Medicare Secondary Payer Act News

Viewpoint: CMS Releases FAQs on Section 111 Penalties

The Centers for Medicare and Medicaid Services (CMS) has published a Frequently Asked Questions (FAQ) document to supplement its recently released Section 111 penalties rule. There were a few crucial clarifications that we highlight below.Start Date for Reporting Data Subject …

Penalties for Late Medicare Secondary Act Reports Take Effect Next Year

Federal rules that impose $1,325-per-day civil money penalties on insurers and other organizations that fail to report settlements or judgments that require payment for a Medicare beneficiary’s medical care will take effect on Oct. 11, 2024. The final version of …

Viewpoint: Settlement Strategies for Workers’ Compensation Claims

Knowing how to effectively negotiate and settle cases is essential when handling workers compensation claims. To do this well, you need to know how to prepare and execute an action plan for settlement. As defined in Webster’s Dictionary, “win” means …

Viewpoint: Third Parties Create a Medicare Headache for Insurers and Employers

Dealing with Medicare-related issues in a workers’ compensation claim has never been anyone’s idea of a “good time” from the employer and insurer’s perspective. From the challenges Medicare creates with settlement, to the uncertainty faced when submitting Medicare Set-Asides (MSAs) …

11th Circuit Revives Investor-Funded Medicare Secondary Payer Act Lawsuit Against Insurers

A Miami-area collections company backed by litigation-funding investors has won another appellate court victory over insurers, persuading a panel of the 11th Circuit Court of Appeals to reinstate Medicare Secondary Payer Act claims that were rejected by the trial court. …

CMS Rules on Settlement Reporting May Sting Insurers and Claimants Both

For years, the federal agency that runs Medicare has been building a trap to snag any settlements that would force taxpayers to pick up the for tab for medical care that should have been paid by others. The Centers for …

SPAC Deal Generates Millions for Lawsuits Against Insurers That Stiffed Medicare

Wall Street’s latest blank-check company promises to be a litigation finance nightmare for property and casualty insurers. MSP Recovery, a Miami-area company that earns revenue by winning lawsuits against insurers, merged with a special purpose acquisition company in July. Last …

Claims Business: Davies, Verisk, Insurity and CIRMA

Davies Acquires TriPlus Davies, an International professional services and technology business based in London, as acquired Boston-based TriPlus Service Inc. TriPlus provides its long term care carrier clients with claims and policy administration management solutions as well as actuarial and …

Appellate Court Revives Medicare Secondary Payer Act Suits by Collection Agents

A federal appellate panel’s ruling opens the floodgates for hundreds of lawsuits filed by collection agents that are seeking billions of dollars in double damages from insurance carriers that are accused of failing to pay for care that ended up …

Court Rejects Deadline Asserted by Insurer in Secondary Payer Act Dispute

Insurers cannot rely on an apparent three-year deadline within the Secondary Payer Act to protect themselves from litigation if they don’t reimburse Medicare for all expenses paid on behalf of a beneficiary, a federal appellate court in Atlanta ruled. The …