The Official Medicare Set Aside Blog And Information Resource

More MSPA Claims 1 Cases Dismissed

Commentary, Medicare Set-Aside Blog, MSP Litigation on August 10, 2016 | Posted by Jennifer Jordan, JD, MSCC

In its continuing efforts to bring MSP recovery claims against all PIP insurers in Florida under an alleged assignment from a now defunct Medicare Advantage Organization, MSPA Claims 1, LLC has had two more of its federal cases dismissed. What is unique about these two dismissals is that they are based on the various assignments […] Continue

MSPA Claims 1, LLC cases Remanded Back to State Court

Commentary, Medicare Set-Aside Blog, MSP Litigation on July 15, 2016 | Posted by Jennifer Jordan, JD, MSCC

In the ongoing pursuit of PIP reimbursements with double damages under the Medicare Secondary Payer Act, two MSPA Claims 1 cases have been remanded back to state court. Because early cases failed in federal court on the basis of plaintiff being required to actually demonstrate responsibility before filing suit, MSPA Claims 1 moved its efforts […] Continue

A Reminder that there is no MSP Reimbursement Obligation Until CMS Makes a Demand

Commentary, Medicare Set-Aside Blog, MSP Litigation on July 14, 2016 | Posted by Jennifer Jordan, JD, MSCC

While always entertained by pro se plaintiffs who take on the man, an interesting MSP opinion came out of the Eastern District of NY on July 11, 2016. Upon receipt of a conditional payment letter, indicating that Medicare had paid $678.60 for treatment related to his accident and in large, bold letters that it was […] Continue

WC Settlement Used as Evidence that Claimant was not Disabled for Purposes of Social Security Benefits

CMS, Commentary, Medicare Advantage, Medicare Set-Aside Blog, Social Security on June 16, 2016 | Posted by Jennifer Jordan, JD, MSCC

Ever wonder what happens after a case is settled in which no MSA was funded because the parties all agreed that there was no reasonable anticipation of Medicare entitlement within the magical 30 months from the date of settlement?  The answer is as we all suspected:  the claimant proceeds to apply for Social Security Disability […] Continue

Purdue Pharma Should Have to Supplement MSAs

Commentary, Medicare Set-Aside Blog, News and Events on May 13, 2016 | Posted by Jennifer Jordan, JD, MSCC

On May 11, 2016, Circuit Judge Steven Coms in Pike County, Kentucky, ruled to unseal records related to a 2007 suit brought by the State’s Attorney General against OxyContin manufacturer Purdue Pharma. The suit was settled in December with no admission of liability and a measly $24 million dollar contribution to the state coffers. As […] Continue

Humana Stretches Boundaries of MSP Private Cause of Action Again

CMS, Commentary, Medicare Set-Aside Blog, MSP Litigation on May 11, 2016 | Posted by Jennifer Jordan, JD, MSCC

In the Fourth Circuit, Humana is currently pursuing reimbursement from the attorneys representing a passenger in a motor vehicle action under the persons in receipt of settlement funds provision of the MSP in yet another attempt to get the courts to grant Medicare Advantage Organizations (MAOs) the same rights as the federal government with regard […] Continue

The MSP is not so “Extraordinary” that it Completely Preempts State Law

CMS, Commentary, Medicare, Medicare Set-Aside Blog, MSP Litigation on May 4, 2016 | Posted by Jennifer Jordan, JD, MSCC

Great MSP case reported out of Pennsylvania on May 3, 2016 involving what the MSP does not do, in particular, preempt state law under any circumstances. From the brief facts presented in the background,  it is clear that the parties arrived at a lump sum settlement agreement and that the insurer attempted to button up […] Continue

MEDVAL Awarded WorkersCompensation.com Best Blog Designation for 2016

Commentary, Medicare Set-Aside Blog, MEDVAL News, News and Events on May 3, 2016 | Posted by Jennifer Jordan, JD, MSCC

In 2015, the workers’ compensation blogger community was saddened by LexisNexis’ decision to discontinue its top blogs awards. However Bob Wilson and some like-minded cohorts decided that need not be the end of a good thing. In an age where anyone with an internet connection has a voice, separating the wheat from the chaff is […] Continue

H.R. 2649 Update

CMS, Commentary, Medicare, Medicare Set-Aside Blog on March 14, 2016 | Posted by Jennifer Jordan, JD, MSCC

On March 7, 2016, H.R. 2649: Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act of 2015 found itself a new co-sponsor. Representative John Larson of Connecticut joined the ranks of congressmen that now know what a Medicare set-aside is and don’t care that there is no legal requirement to participate in the voluntary CMS […] Continue

U.S. Supreme Court ERISA Ruling Instructive to Opt-Out Proponents

Commentary, Medicare Set-Aside Blog, State Regulations, Work Comp on March 4, 2016 | Posted by Jennifer Jordan, JD, MSCC

Although not our standard MSP fare, the U.S. Supreme Court ruling on March 1, 2016, in Gobeille v. Liberty Mutual Insurance Company caught my attention nonetheless as potentially interesting to our work comp readers so here goes. The Court ruled that ERISA reporting requirements preempted a Vermont law that requires certain entities to report payments […] Continue