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Proposed Rule on Section 111 Penalties: Issues to Consider
CMS’s recent release of its Proposed Rule on Section 111 penalties moves the industry one step closer to CMS imposing penalties for...
Matthew T. Dorius, Esq.
Mar 4, 2020
Proposed Rule for Section 111 Penalties Just Released!
CMS has now released a Proposed Rule on Civil Monetary Penalties for non-compliance with Section 111 reporting obligations. The Proposed...
Matthew T. Dorius, Esq.
Feb 14, 2020
Update on Notice of Proposed Rulemaking Involving Section 111 Penalties
On January 24, 2020, the Office of Information and Regulatory Affairs completed its review of a Notice of Proposed Rulemaking (NPRM)...
Matthew T. Dorius, Esq.
Feb 6, 2020
CMS Town Hall Presentation Regarding Commercial Repayment Center Recovery Issues
On January 14, 2020, CMS hosted a Town Hall presentation to discuss issues involving the recovery of conditional payment claims by the...
Matthew T. Dorius, Esq.
Jan 23, 2020
Visit Us at the New York Self Insurers Association (NYSIA) Conference This Week
If you are attending the New York Self Insurers Association Conference at the Roosevelt Hotel in New York this week, be sure to stop by...
Melisa Zwilling
Jan 13, 2020
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...
Matthew T. Dorius, Esq.
Jan 13, 2020
CMS Continues to Delay Issuing Regulations on Future Medical Expenses
In its most recent Regulatory Agenda, the Department of Health and Human Services again included a notice of a proposed rule on...
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...
Matthew T. Dorius, Esq.
Jan 13, 2020
U.S. District Court Dismisses Action by MAO Assignee Due to Lack of Standing
In Humana, Inc. v. St. Jude Med., LLC, 2019 U.S. Dist. LEXIS 223313, the United States District Court for the Southern District of...
Meggie R. Krombach, Esq.
Jan 10, 2020
Federal District Court Applies Three Year MSP Statute of Limitations to Medicare Advantage Plans
In MSP Recovery Claims v. Farmers Ins. Exch., 2019 U.S. Dist. LEXIS 106417 (C.D. Cal. June 12, 2019), the U.S. District Court for the...
Matthew T. Dorius, Esq.
Jan 10, 2020
Plaintiffs’ Firm Pays Lump Sum to Resolve Conditional Payment Claims and Agrees to Establish Plan fo
The United States Attorney’s Office for the Eastern District of Pennsylvania recently announced that Simon and Simon, P.C., a...
Jessica A. Hurst, Esq.
Jan 10, 2020
CMS to Host Webinar to Discuss CRC ORM Recovery Issues
CMS recently announced that they are hosting a webinar to discuss issues with CRC’s recovery of conditional payment claims in cases...
Matthew T. Dorius, Esq.
Jan 8, 2020
Proposed Class-Action Suit Dismissed for Lack of Jurisdiction
In the latest installment of the ongoing case MAO-MSO Recovery II, LLC v. State Farm, (2019 U.S. Dist. LEXIS 204397 (C.D. Ill. Nov. 25,...
Amber M. Parris, Esq.
Dec 18, 2019
Lawsuit Against Medicare Dismissed for Failure to Exhaust Administrative Remedies
In Yatsko v. Roehl, (2019 U.S. Dist. LEXIS 194600 (D. Md. November 7, 2019)), the plaintiff, a Medicare beneficiary, was injured in a car...
Amber M. Parris, Esq.
Dec 18, 2019
CMS Releases 2020 Recovery Thresholds for Non-Group Health Plan Cases
CMS recently issued notice of the “2020 Recovery Thresholds for Certain Liability Insurance, No-Fault Insurance, and Workers’...
Meggie R. Krombach, Esq.
Dec 18, 2019
CMS Announces Changes to WCMSA Reference Guide including Extension of Time Frame for Amended Reviews
CMS recently released an updated version of the Workers’ Compensation Medicare Set-aside Arrangement Reference Guide. The new version of...
Amber M. Parris, Esq.
Nov 20, 2019
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