CMS recently announced that they are hosting a webinar to discuss issues with CRC’s recovery of conditional payment claims in cases...

A U.S. District Court followed the trend of permitting a Medicare Advantage Organization (“MAO”) to sue pursuant to the Medicare...

As you will recall, in August 2016, the United States Court of Appeals for the Eleventh Circuit, following the lead of the Third...

William Ashmore presented to Hartford Hospital for a non-emergency, planned procedure. It was during his hospital stay that he passed...

In January 2017, we posted an article concerning a recent case, Cali. Ins. Guar. Ass’n v. Burwell, No. 2:15-cv-01113-ODW (FFMx), 2017...

In the present case, Claims v. Co. V., No. 16-20338-CIV-LENARD/GOODMAN, 2017 U.S. Dist. Ct. LEXIS 43755, the Plaintiff (MSPA Claims 1,...

It is a familiar story for many insurance carriers and self-insured employers—Medicare has asserted a number of conditional payment...

In Cheryl Nelson & Geico Gen. Ins. Co. v. Medi-Cal., No. 1:16-cv-01328-LJO-BAM, 2016 U.S. Dist. Ct. LEXIS 153596 (E.D. Cal., November 4,...

What qualifies as a “demonstrated responsibility” sufficient to proceed under the private cause of action provision of the Medicare...

In Anderson v. Burwell, 2016 U.S. Dist. LEXIS 26633 (March 3, 2016), a case arising out of the United States District Court for the...