The Official Medicare Set Aside Blog And Information Resource

As MAPs Continue Recovery Efforts, Florida Court Says the MSP Does Not Preempt State Law

Medicare Advantage, MSP Litigation, MSP News on October 16, 2018
Posted by Jean S. Goldstein, JD

You may recall that we recently blogged about whether the Medicare Secondary Payer (MSP) Act, a Federal law, preempts State law.  A Maryland case quite succinctly addressed this question several months ago finding that State law is not preempted by the MSP if certain conditions are met.  This question was also addressed recently in a […] Continue

Conditional Payments: When Does the Time Clock Run Out?

Conditional Payments, Medicare Advantage, MSP Litigation on October 1, 2018
Posted by Jean S. Goldstein, JD

Last week, in MSPA Claims 1 v. Kingsway Amigo Ins. Co.,  the 11th Circuit addressed the appropriate application of the statute of limitations under the Medicare Secondary Payer Act (MSPA).  At issue in the matter, was whether the Plaintiff, an assignee of a Medicare Advantage Organization (MAO), timely pursued a claim against the Defendant, a primary […] Continue

Another MSP Case Invades a Jurisdiction: The Sixth… This Time.

Medicare Advantage, Medicare Set-Asides, MSP Litigation on July 19, 2018
Posted by Jean S. Goldstein, JD

Another Medicare Secondary Payer (MSP) case involving the well-known entities, MAO-MSO, Recovery II, LLC MSP Recovery, LLC and MSPA Claims 1, LLC (“Plaintiffs”) has arisen out of the Sixth Circuit.[1] (MAO-MSO Recovery II, LLC v. Progressive Corp., No. 1:17CV390, 2018 U.S. Dist. LEXIS 119046, (N.D. Ohio July 17, 2018).  This recent opinion is issued in […] Continue

Another MSP Case; Another Court’s Interpretation: Court finds Personal Representative Has Standing to Bring Private Cause of Action  

Medicare Set-Aside Blog, MSP Litigation, MSP News on June 12, 2018
Posted by Jean S. Goldstein, JD

Last week, the Fourth Circuit was added to the list of recent jurisdictions addressing the private cause of action provision under the Medicare Secondary Payer act.  The Fourth Circuit has jurisdiction over the District Courts in the states of Maryland, North Carolina, South Carolina, Virginia and West Virginia. In Netro v. Greater Balt. Med. Ctr. […] Continue

MAP Action Dismissed; Illinois Does Not Join Jurisdictions Allowing for Double Damages, Private Cause of Action…For Now

Medicare Advantage, Medicare Set-Aside Blog, MSP Litigation, MSP News on June 5, 2018
Posted by Jean S. Goldstein, JD

Over the last several years, we have blogged about MSP Recovery, LLC, a law firm, that has been championing claims nationwide on behalf of Medicare Advantage Plans (MAP).  In their pursuits, MSP Recovery, has alleged that Non-Group Health Plans (NGHPs) are failing to make payment first, and have allowed secondary payers, particularly Medicare Advantage Organizations […] Continue

Did the United States Court of Appeals for the Sixth Circuit Just Pave the Way for More MSP Private Causes of Action?

Medicare Set-Aside Blog, MSP Litigation, MSP News on April 18, 2018
Posted by Jean S. Goldstein, JD

In today’s day and age of conditional payment recoveries, whenever a settlement of a claim is imminent, parties begin to worry about what possible challenges may impede the settlement, or even arise after settlement.  Yesterday, an interesting case from the United States Court of Appeals for the Sixth Circuit was issued; and while the fact […] Continue

CMS Increased Conditional Payment Demand by $142k: New York Supreme Court Vacates Settlement Agreement

CMS, Conditional Payments, Medicare Set-Aside Blog, MSP Litigation on March 26, 2018
Posted by Jean S. Goldstein, JD

An interesting case came out of the Supreme Court of New York City on Friday, challenging whether a settlement agreement may be declared null and void based upon an erroneous assumption of the total sum of conditional payments made by Medicare.  Mayo v. NYU Langone Med. Ctr., 2018 NY Slip Op 30456(U) (Sup. Ct.). The parties litigated […] Continue

11th Circuit Finds MAOs May Bring Double Damages Private Cause of Action Against Medical Providers

CMS, Medicare Advantage, Medicare Set-Aside Blog, MSP Litigation on March 21, 2018
Posted by Jean S. Goldstein, JD

The 11th Circuit issued an opinion yesterday on a Motion to Dismiss on a claim addressing a new question, one they have never been faced with before: Whether an MAO has a private cause of action against the recipient, or a provider of a primary payment. Claims v. Bayfront Hma Med. Ctr., 2018 U.S. Dist. […] Continue