Medicare Beneficiary Lacks Standing to Assert Private Cause of Action under the Medicare Secondary P
Recently, the Sixth Circuit Court of Appeals upheld the district court’s decision that a Medicare beneficiary did not have standing to...
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Melisa Zwilling
Apr 27, 2017
U.S. District Court Upholds Conditional Payment Claim Demand Amount
Parties often wait to finalize settlement until initial information concerning conditional payment claims is received. While this is...
Melisa Zwilling
Mar 31, 2017
U.S. District Court Again Follows Eleventh Circuit Decision Finding that the Existence of a Contract
MSP Recovery, LLC v. Allstate Ins. Co., No. 15-21532, 2017 U.S. Dist. LEXIS 41424 (U.S. Dist. S.D. Fla., March 21, 2017) was recently...
Melisa Zwilling
Mar 31, 2017
U.S. District Court Again Relies on Eleventh Circuit Decisions And Allows Medicare Advantage Organiz
In the recent case, Mspa v. Century Sur. Co., No. 16-20752, 2017 U.S. Dist. LEXIS 37040 (U.S. Dist. S.D. Fla., March 15, 2017), the...
Melisa Zwilling
Mar 27, 2017
U.S. District Court Looks To Eleventh Circuit Decision In Deciding Medicare Advantage Organization’s
In September 2016, we informed you of an Eleventh Circuit decision in which the Circuit Court found that a contractual obligation alone...
Melisa Zwilling
Sep 21, 2016
Alert! Eleventh Circuit: Contractual Obligation Sufficient to Establish “Demonstrated Responsibility
What qualifies as a “demonstrated responsibility” sufficient to proceed under the private cause of action provision of the Medicare...
Melisa Zwilling
Aug 30, 2016
ALERT: Eleventh Circuit Holds That Medicare Advantage Organization Entitled to Double Damages Under
A number of federal district courts have followed the ruling of the Third Circuit in In re Avandia Sales Practices, and Products...
Melisa Zwilling
May 12, 2016
US District Court: Involvement of MSPA Does Not Create a Federal Question
In Mikiewicz v. Hamorski and Erie Insurance Exchange, 2016 U.S. Dist. LEXIS 58859 (May 3, 2016), the United States District Court for the...
Melisa Zwilling
Nov 11, 2015
New Process for Obtaining Final Demand PRIOR to Settlement Coming Soon!
On Monday, November 9th, CMS issued an alert regarding the ability to obtain a Final Conditional Payment Amount prior to settlement...
Melisa Zwilling
Oct 12, 2015
US District Court: Requires More Than Contractual Obligation to Establish Primary Payer Responsibili
We continue to see courts acknowledging the rights of Medicare Advantage Organizations (MAOs) to pursue an action for recovery of...
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