On January 4, 2019, CMS released its updated Non-Group Health Plan User Guide Version 5.5 detailing changes made to Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007.

The Private Cause of Action provision of the Medicare Secondary Payer Act (MSP) (42 U.S.C. Section 1395 y(b)(3)A) remained  the focus of much of the MSP litigation in  2018.

The rising use of telehealth has made its way into the workers’ compensation arena thanks to possible cost-saving strategies along with effective delivery of care.

In yet another ruling concerning Medicare Advantage Organizations’ rights to pursue the private cause of action under the Medicare Secondary Payer Act, a U.S. District Court in Illinois held that assignee-organizations may pursue rights of recovery on behalf of assignor-MAOs with valid assignment agreements.

The Medicare Secondary Payer (MSP) Act provides that Medicare will make conditional payments for medical services when a primary plan has not made, or cannot reasonably be expected to make, payments for those services.