CMS Again Proposes to Solicit Public Comments on Section 111 Reporting Penalties
The most recent Regulatory Agenda for the Department of Health and Human Services includes another notice of a proposed rule on Civil...
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Matthew T. Dorius, Esq.
- Jan 13, 2020
Reminder: Conditional Payment Letters From CMS Do Not Apply to Medicare Advantage Plans and Medicare
According to current data from CMS, over 36 percent of Medicare beneficiaries are enrolled in Medicare Advantage Plans and over 41...
Melisa Zwilling
- Sep 19, 2018
Sixth Circuit Remands Case to District Court for Further Consideration Regarding Standing
Duncan v. Liberty Mutual Insurance Company, arises following a motor vehicle accident the late David Duncan was involved in on January...
Melisa Zwilling
- Aug 16, 2018
Medicare Compliance and the Opioid Epidemic - How Policy Changes May Impact Future Treatment
The opioid epidemic has become the subject of much conversation over the last few years following increases in substance abuse and deaths...
Melisa Zwilling
- Jul 31, 2018
U.S. District Court Dismisses Action Against CMS Due to Lack of Subject-Matter Jurisdiction
In Country Mutual Insurance Company v. Decker, 2018 U.S. Dist. LEXIS 115281 (July 11, 2018), the United States District Court for the...
Melisa Zwilling
- Jul 16, 2018
Law Firm Reaches Agreement with the United States Department of Justice Regarding the Firm’s Failure
The U.S. Attorney’s Office for the Eastern District of Philadelphia issued a press release regarding a settlement agreement with a...
Melisa Zwilling
- Mar 23, 2018
U.S. District Court Holds that a Plaintiff Must Exhaust Administrative Proceedings Prior to Judicial
A U.S. District Court affirmed that a plaintiff must exhaust the administrative appeals process before seeking a declaratory judgment...
Melisa Zwilling
- Feb 27, 2018
UPDATE: Eleventh Circuit Court of Appeals Upholds District Court Decision Giving Medicare Advantage
As you will recall, in August 2016, the United States Court of Appeals for the Eleventh Circuit, following the lead of the Third...
Melisa Zwilling
- Sep 26, 2017
State Court Refuses to Reduce Plaintiff's Economic Damages Award Due to Medicare's Subrogati
William Ashmore presented to Hartford Hospital for a non-emergency, planned procedure. It was during his hospital stay that he passed...
Melisa Zwilling
- Jul 19, 2017
CMS Releases New Re-Review Option for WCMSAs
On July 10, 2017, CMS issued an updated Workers’ Compensation Medicare Set-aside Portal (WCMSAP) User Guide which includes an expanded...
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