In Stone v. State Auto Mut. Ins. Co., 2017 U.S. Dist. LEXIS 21737, Billy Ray Stone (“Stone”) filed an action against State Automobile...

CMS recently issued an alert stating that it expects to expand the existing WCMSA re-review process. This potential expansion will...

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

On December 12, 2016, CMS issued an Alert regarding changes in the Section 111 TPOC reporting threshold for liability, no-fault and...

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,...

CMS recently indicated that changes had been made to its review of MSA proposals involving denied injuries. These changes could have...

The present action, Geico Gen. Ins. Co. v. Dep’t of the Navy Med. Care Recovery Unit, arises out of a motor vehicle accident where June...

Courts continue to consider and rule on the rights of Medicare Advantage Organizations (MAOs) under the Medicare Secondary Payer Act...

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

Paragraph XIV of Mississippi’s proposed fee schedule provides that in the event that a claimant settles his or her workers’ compensation...

42 CFR §405.900 establishes the requirements for appeals of initial determinations for benefits under Part A or Part B of Medicare. Under...

In Bindrum v. Am. Home Assur. Co., 2016 Vt. Unpub. LEXIS 150 (Vt. Aug. 19, 2016), the Supreme Court of Vermont recently affirmed the...

A number of federal district courts have followed the ruling of the Third Circuit in In re Avandia Sales Practices, and Products...

In Sexton v. Medicare, 2016 U.S. Dist. LEXIS 89818, Medicare made conditional payments for Plaintiff’s treatment after Plaintiff was...

On June 9th, CMS issued an alert indicating that they are in fact considering the review of Medicare Set-asides in both liability and...

In Humana Ins. Co. v. Paris Blank LLP, No. 3:16CV79-HEH, 2016 U.S. Dist. Ct. LEXIS 61814 (E.D. Va., May 10, 2016), Humana Insurance...