Hear what our attorneys are saying

15
Jan 2019

Medicare and the Opioid Epidemic

By Rasa Fumagalli     

  As of January 1, 2019, Medicare Part D prescription drug plans began implementing a three part plan to help combat the nation’s opioid epidemic.  The plan focuses on the prevention of new cases of opioid use disorder and the treatment of opioid dependent and addicted patients through the use of nationwide utilization data.  Close
Read the full article…

Read More
15
Jan 2019

Section 111 Updates: Thresholds for 2019, Proposed Changes

By Vinal Patel     

  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.  Section 111 of the MMSEA details the reporting requirements by Responsible Reporting Entities (RREs) to CMS regarding the potential recovery by Medicare to
Read the full article…

Read More
15
Jan 2019

Private Cause of Action 2018

By Vinal Patel     

  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. Although one form or another of the MSP Recovery LLC entity continued to file complaints on behalf of Medicare Advantage Organizations (MAOs) to recover payments
Read the full article…

Read More
15
Jan 2019

Conditional Payments; Then and Now

By MSA Team     

  By:  Christi Allison and Tim Mercer In February, 2018, Performant Financial Corporation (parent organization of Performant Recovery, Inc. “Performant”) replaced CGI Federal as the lead contractor in the Commercial Repayment Center (“CRC”) operations.  Performant is now responsible for monitoring and collecting any conditional payments which Medicare may have made in Workers’ Compensation claims at the
Read the full article…

Read More
15
Jan 2019

A New WCRC Contractor, Changes to Allocations and the WCMSA Reference Guide

By Julie A. Garrison     

  The Centers for Medicare and Medicaid Services (CMS) is tasked with approving future medical plans in settlements for workers’ compensation claims of Medicare beneficiaries or those who will soon become Medicare eligible. Known as Workers’ Compensation Medicare Set-Asides (MSA), these plans may be submitted to CMS who, in turn, contracts with a Workers’ Compensation
Read the full article…

Read More