CMS Announces Enhancements to the MSPRP
The Centers for Medicare & Medicaid Services (CMS) announced on June 1, 2020 upcoming enhancements to the Medicare Secondary Payment Recovery Portal (MSPRP). As readers
Medicare Advantage Case Law 11th Circuit Court of Appeals: Private Cause of Action Update
Medicare Advantage plans have, in many areas, moved aggressively to wield the Medicare Secondary Payer “private cause of action” and obtain reimbursement for payments
What claims are Section 111 reportable, and when are they to be reported?
There are multiple factors to consider when determining if a claim is reportable and when it should be reported to Medicare. In fact, CMS published nearly 4000 words on
Movement in the MSP Compliance Realm? Update on Liability and No-Fault Medicare Set-Asides
In a previous Industry News Bulletin, we noted that CMS seemed to be taking affirmative first steps on Liability Medicare Set-Aside Arrangements (LMSAs) and No-Fault
Why does the MSP industry use the phrase “consider and protect” when discussing Medicare’s interest?
Recently you may have seen some back and forth about the plain language of the Medicare Secondary Payer (MSP) Statute found at 42 USC 1395y(b). The discussion focused on
California Federal Court: CMS May Not Seek Reimbursement for Conditional Payments That are Unrelated to the Claim
On January 5, 2017 in the matter of California Insurance Guarantee Association (CIGA) v. Burwell(i), a Federal Court granted CIGA’s Motion for Partial Summary Judgment
CMS Announces Rollback of Rule Change Impacting Legal Zero MSAs
ExamWorks Compliance Solutions recently issued an Industry News Bulletin concerning an abrupt rule change to a long-standing CMS policy regarding approval of Legal Zero
Federal Appellate Court Holds Medicare Advantage Plan Assignees May Maintain Claims for Reimbursement Against No-Fault and PIP Plans
The 11th Circuit U.S. Court of Appeals, which includes Florida, Alabama and Georgia under its jurisdiction, has found that Medicare Advantage Plans (MAPs) may assign