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CMS Releases Recovery Thresholds for Non-Group Health Plan Cases
CMS recently released the results of its ‘Computation of Annual Recovery Thresholds for Certain Liability Insurance, No-Fault Insurance,...
Melisa Zwilling
Nov 28, 2018
Florida District Court Determines Statute of Limitations for Suits Under the MSPA
In MSPA Claims 1, LLC, v. Kingsway Amigo Insurance Company, the defendant, Kingsway Amigo Insurance Company (Kingsway), argues that the...
Melisa Zwilling
Nov 5, 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
Sep 19, 2018
Consideration for Expansion of Medicare Set-Aside (MSA) Arrangements: UPDATE
As we previously reported, CMS has stated that it is considering expansion of the Medicare Set-aside review program to include review of...
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
Aug 16, 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 31, 2018
U.S. District Court Sanctions MSP Recovery and Counsel for Misstatement in Pleadings
We are continuing to monitor the nationwide string of suits filed by MAO-MSO Recovery II, LLC and MSP Recovery, LLC (“Plaintiffs”)...
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
Jul 16, 2018
Fourth Circuit Court of Appeals Makes Important Ruling Regarding Government’s Partial Assignment of
In Netro v. Greater Baltimore Medical Center, Inc., 2018 U.S. App. LEXIS 14835 (4th Cir. 2018), the United States Court of Appeals for...
Melisa Zwilling
Jun 18, 2018
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...
Melisa Zwilling
Apr 24, 2018
U.S. District Courts Dismiss Claims Brought by MAO-MSO Recovery II
MAO-MSO Recovery II, LLC (“MAO-MSO”) has filed putative class action suits against multiple insurance carriers claiming to be assignees...
Melisa Zwilling
Apr 23, 2018
State Court Vacates Settlement due to Error Regarding Medicare Conditional Payment Claims
In Mayo v. NYU Langone Medical Center, a New York state court vacated a settlement agreement (“the Agreement”), finding that a mutual...
Melisa Zwilling
Apr 12, 2018
District Court Affirms Medicare Advantage Organization’s Right to Sue Primary Plans Pursuant to the
A U.S. District Court followed the trend of permitting a Medicare Advantage Organization (“MAO”) to sue pursuant to the Medicare...
Melisa Zwilling
Apr 6, 2018
Fifth Circuit District Court Allows MAO Action Seeking Reimbursement from Tort Settlement Fund to Go
On March 16, 2018, the United States District Court for the Southern District of Texas denied defendant’s Motion to dismiss in Humana,...
Melisa Zwilling
Apr 6, 2018
11th Circuit District Court: MAO Action Against Treatment Provider Under PCOA Provision of MSP May P
A U.S. District Court for the Southern District of Florida recently held that a Medicare Advantage Organization (MAO) may bring an action...
Melisa Zwilling
Mar 29, 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
Mar 23, 2018
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