Medicare Advantage plans have, in many areas, moved aggressively to wield the Medicare Secondary Payer “private cause of action” and obtain reimbursement for payments

Standard operating procedure when settling a personal injury claim: parties should first determine if a plaintiff is a Medicare beneficiary, and once confirmed should

On Tuesday, February 26, 2019, the United States District Court for the Middle District of Pennsylvania held that the mere filing of a lawsuit by the Centers for

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

What is supposed to happen and what actually happens for level three conditional payment appeals?

A Federal Magistrate in a Massachusetts Federal Court dismissed a Navy veteran’s attempt to have the reliance upon Treasury offsets to collect Medicare conditional

Anew decision from United States federal court in Connecticut opens the door for Medicare Advantage organizations (MAOs) to use the Medicare Secondary Payer statutes

In September of this year the Centers for Medicare & Medicaid Services (CMS) announced the award of a new Workers’ Compensation Review Contractor (WCRC) contract to

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