The Official Medicare Set Aside Blog And Information Resource

Eleventh Circuit Finds Medicare Conditional Repayment Lawsuit Not Time-Barred By 3-Year Claims Filing Provision

Conditional Payments, Medicare Advantage, Medicare Set-Aside Blog, MSP Litigation on February 27, 2020
Posted by Jean S. Goldstein, JD, CMSP

The Eleventh Circuit recently opined that the 3-years claims filing provision found within the Medicare Secondary Payer Act does not apply to a Medicare Advantage Organization (MAO) when filing suit.  The Eleventh Circuit case was initiated by Plaintiff, MSPA Claims, which is a familiar entity in the Medicare Secondary Payer (MSP) litigation space.  As with […] Continue

CMS Hosts Townhall Meeting to Address MSP Recovery Topics and Statute of Limitations

CMS, Conditional Payments, Mandatory Insurer Reporting, Medicare Set-Aside Blog on January 21, 2020
Posted by Jean S. Goldstein, JD, CMSP

Last week, on January 14th, the Centers for Medicare & Medicaid Services hosted a townhall meeting, complete with a slide presentation to discuss several Medicare Secondary Payer Recovery topics.  During the townhall meeting, CMS discussed the conditional payment recovery process along with providing time at the end of the presentation for questions.  The slides from […] Continue

Warning: Another Law Firm Reprimanded for Failing to Repay Medicare Conditional Payments

Compliance, Conditional Payments, Medicare Set-Aside Blog, MSP News on January 9, 2020
Posted by Jean S. Goldstein, JD, CMSP

Yesterday, the U.S. Department of Justice’s Attorney’s Office for the Eastern District of Pennsylvania issued a press release stating that another Philadelphia-based personal injury law firm, has entered into a settlement agreement with the United States to resolve allegations that it failed to reimburse Medicare Conditional Payments.  You may recall we saw a similar action […] Continue

CMS to Host Town Hall Meetings to Discuss Medicare Secondary Payer Recovery Topics

CMS, Conditional Payments, Medicare Set-Aside Blog, MSP News on December 5, 2019
Posted by Jean S. Goldstein, JD, CMSP

The Centers for Medicare & Medicaid Services issued an alert today that it will be hosting two town hall meetings to discuss common Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) Ongoing Responsibility for Medicals (ORM) and Group Health Plan (GHP) recovery topics. The first town hall will be held on January 14, 2020 at 1:00 […] Continue

Ninth Circuit: Guaranty Fund Is Not Deemed a Primary Plan as Related to Non-Covered Claims; States No Obligation to Reimburse Medicare Conditional Payments on Subset of Claims

CMS, Conditional Payments, Medicare Set-Aside Blog, MSP Litigation, MSP News on October 15, 2019
Posted by Jean S. Goldstein, JD, CMSP

Last week, the Ninth Circuit United States Court of Appeals issued an important decision involving the Centers for Medicare & Medicaid Services, and the California Insurance Guaranty Fund (CIGA) in Cal. Ins. Guarantee Ass’n v. Azar, Nos. 17-56526, 17-56528, 2019 U.S. App. LEXIS 30339 (9th Cir. Oct. 10, 2019). We last discussed this case in […] Continue