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

Meet us at the Annual California Division of Workers’ Compensation Conference: March 26-27

MEDVAL News on February 26, 2020
Posted by Jean S. Goldstein, JD, CMSP

The largest workers’ compensation educational event in California is just one month away. The event will be held in Los Angeles and is a great opportunity to learn more about most current topics and issues challenging the workers’ compensation sector, from the onset of a claim to the final settlement.  For a full agenda of […] Continue

FDA Grants OTC Status to Voltaren® 1% Gel

FDA, Medicare Set-Aside Blog, Medicare Set-Asides, Rx/Pharmacy on February 21, 2020
Posted by Leah King, PharmD, JD, Independent Pharmacy Consultant

Last Friday, while many of us may have been focused on Valentine’s Day activities, the Food and Drug Administration (FDA) was busy granting over-the-counter status to three products which were previously available only by prescription. One of those products was Voltaren (diclofenac) 1% gel, which is manufactured by GSK. When the product makes its OTC […] Continue

Proposed Civil Money Penalties Rule for Medicare Reporting to be Released

Mandatory Insurer Reporting, Medicare Set-Aside Blog, MSP News on February 14, 2020
Posted by Jean S. Goldstein, JD, CMSP

The Medicare Medicaid SCHIP Extension Act of 2007 (MMSEA) imposed Mandatory Insurer Reporting obligations on all Responsible Reporting Entities (RREs) when enacted in 2009.  These mandatory requirements specifically imparted obligations on all RREs and required entities to provide the Centers for Medicare & Medicaid Services (CMS) with data on claims that involve Medicare beneficiaries.  Furthermore, […] Continue

The Opioid Crisis . . . Is It Still a Crisis?

Medicare Set-Aside Blog, Opioids, Rx/Pharmacy on February 4, 2020
Posted by Leah King, PharmD, JD, Independent Pharmacy Consultant

During the past year and a half, we’ve detailed the efforts of the federal government and many state governments to combat the opioid crisis. We devoted a blog series to the Department of Health and Human Services’ five-part strategy to curb the epidemic. We’ve discussed educational efforts for prescribers and revisions to prescribing guidelines which […] Continue