News & Analysis as of

Medicare Medicare Secondary Payer Act

Goldberg Segalla

[Webinar] Medicare Tune Up: Boosting Efficiency and Minimizing Costs - August 8th, 12:00 pm - 1:00 pm EDT

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As Medicare secondary payer penalties take effect this fall, find out what’s new, what’s on the horizon, and what to watch out for to avoid pitfalls. Join Goldberg Segalla partners Philip Unwin and Jennifer Santoro for a free...more

King & Spalding

CMS Publishes Final Rule Regarding CMPs for Late Reporting by Medicare Secondary Payers

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On October 11, 2023, CMS published a final rule (the Final Rule) regarding how and when CMS will impose civil monetary penalties (CMPs) for Medicare secondary payers (MSPs) that untimely report required information. The Final...more

Pullman & Comley - Labor, Employment and...

Group Health Plans and Medicare Secondary Payer Rules: Do the Mandatory Reporting Obligations Apply to You?

The Medicare Secondary Payer provisions (MSP) apply to group health plans sponsored by employers with 20 or more employees, in both the private and public sectors. MSP’s mandatory reporting requirements are designed to...more

Chartwell Law

The Chartwell Chronicles: Medicare & Medicaid

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In Episode 13 of The Chartwell Chronicles, hosts Colin Davis and Brittany Atkinson discuss Medicare and Medicaid and how they relate to New Jersey workers' compensation. Topics of discussion include an overview of both...more

Epiq

Medicare and the Roundup Global Lien Resolution Program

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The Centers for Medicare and Medicaid Services (CMS) have been operating a global Medicare Secondary Payer (MSP) approach in healthcare lien resolution for mass tort, class action, and asbestos trust settlements for more...more

Groom Law Group, Chartered

CAA 2023 Includes HSA Telehealth Relief, MHPAEA, Medicare, and Medicaid Changes

Last week the Senate passed the Continuing Appropriations Act, 2023 (“CAA23”).  The House of Representatives will likely consider the measure today, and President Biden is expected to sign the bipartisan measure into law...more

Health Care Compliance Association (HCCA)

[Virtual Event] Healthcare Enforcement Compliance Conference - November 7th - 9th, 8:55 am - 3:30 pm CST

Hear directly from the enforcement community - Want to gain insight into properly monitoring, detecting, investigating, and managing violations? Join us virtually at HCCA’s Annual Healthcare Enforcement Compliance...more

ArentFox Schiff

Supreme Court Holds Benefit Plan Limiting Dialysis Reimbursement Does Not Run Afoul of Medicare Secondary Payer Act

ArentFox Schiff on

On June 21, 2022, the Supreme Court concluded, in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., No. 20-1641, 2022 WL 2203328 (U.S. June 21, 2022), that the terms of a benefit plan limiting...more

Kilpatrick

Supreme Court Upholds ERISA Plan Design for Dialysis Coverage

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The Supreme Court released an opinion Tuesday, June 21, 2022, holding that the Marietta Memorial Hospital Employee Health Benefit Plan (“Marietta Plan”) did not violate the Medicare Secondary Payer statute merely because it...more

Epstein Becker & Green

Five More Opinions and Justice Gorsuch Shows an Independent Streak: SCOTUS Today

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I’m currently in the wilds of Alaska, learning about the training of sled dogs. Nevertheless, word of the Supreme Court’s five most recent decisions has traveled northward. While none of these decisions is earthshaking, they...more

Faegre Drinker Biddle & Reath LLP

Supreme Court Decides Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc.

On June 21, 2022, the Supreme Court decided Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., No. 20-1641, holding that a group health plan that uniformly provides limited benefits for outpatient...more

Fisher Phillips

The Cost of Employee Benefits Non-Compliance Just Went Up . . . Again

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The U.S. Department of Health & Human Services (HHS) just announced increased penalty amounts for entities who violate the privacy, security, and breach notification rules under the Health Insurance Portability and...more

Rivkin Radler LLP

Supreme Court to Hear DaVita’s Medicare Secondary Payer Act Case

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The U.S. Supreme Court has agreed to review the scope of the Medicare Secondary Payer Act (MSPA) as it relates to the treatment of patients with end-stage renal disease (ESRD). The case to be heard by the high court, Marietta...more

Dorsey & Whitney LLP

The Supreme Court - November 5, 2021

Dorsey & Whitney LLP on

Marietta Memorial Hospital v. Davita Inc., No. 20-1641: This case, involving the Medicare Secondary Payer Act, presents the following questions...more

Rumberger | Kirk

Court Clarifies Applicability of Statute of Limitations for the Medicare Secondary Payer Act’s Private Cause of Action

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RumbergerKirk attorneys Nicole Smith, Samantha Duke, and Jeffrey Grosholz secured a final summary judgment in MSPA Claims 1, LLC v. Tower Hill Prime Insurance Co. in the United States District Court for the Northern District...more

ArentFox Schiff

The Medicare Secondary Payer Act Prohibits Disparate Impact Discrimination, the Sixth Circuit Rules

ArentFox Schiff on

The Sixth Circuit has issued an important decision that condemns plan provisions that provide different benefits based on a patient’s need for continued dialysis, even if the provision applies to all dialysis patients and not...more

Hinshaw & Culbertson LLP

The LHD/ERISA Advisor: Sixth Circuit Rejects MSPA and ERISA Discrimination Claims

Seeking to control healthcare costs, many group health plans have adopted amendments that lower reimbursement rates for the treatment of end-stage renal disease ("ESRD"), which requires long-term dialysis treatment or a...more

Epiq

Recent Settlements Warn Of Consequences For Failure To Reimburse Medicare

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When a law firm settles or resolves a personal injury claim on behalf of a client, the client’s health insurer has a right to be reimbursed for its past expenditures on the related injury. Reimbursement requests become...more

Carlton Fields

Retiree Medical Not Restricted by Medicare Secondary Payer Rules

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This article should interest employers who are offering or thinking about offering retiree medical coverage and should especially interest local governmental entities that are required to offer retiree medical coverage under...more

Miles & Stockbridge P.C.

Can Tort Victims Recover the Total Amount of Medical Expenses Billed?

Good news for defendants. The Court of Special Appeals recently decided that the Medicare Secondary Payer Act does not preempt the Maryland statute that allows post-trial motions to reduce judgments for past medical expenses....more

King & Spalding

U.S. District Court Vacates Secretary’s Policy of Counting Exhausted Patient Days and Medicare Secondary Payor Days as Days...

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On August 13, 2018, the United States District Court for the Eastern District of Washington decided Empire Health Foundation v. Price by vacating the Secretary’s policy of counting exhausted patient days and Medicare...more

Holland & Knight LLP

Ruling: Medical Providers Not Subject to Double Damages Under Medicare Secondary Payer Act

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• In a matter of first impression, the U.S. District Court for the Middle District of Florida has ruled that a private right of action under the Medicare Secondary Payer Act (MSP Act), which provides for double damages in the...more

Robinson+Cole Class Actions Insider

Medicare Secondary Payer Act Class Actions

There have been a substantial number of putative class actions filed recently against insurers involving the Medicare Secondary Payer Act (MSPA). These cases are typically filed by assignees of Medicare advantage...more

Jones Day

Second Circuit Affirms Dismissal of FCA Cases

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The Second Circuit affirmed the dismissal of two False Claims Act ("FCA") cases brought by private relators against insurance and other companies based on the alleged failure to reimburse the Centers for Medicare & Medicaid...more

Carlton Fields

Look, up in the sky! It’s a bird, it’s a plane, it’s… uh oh… a Super Lien!

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Liability insurers have always gnashed teeth over the dreaded “super lien” – aka a lien asserted by Medicare for treatment expenses where the patient is reimbursed through a settlement obtained in personal injury litigation....more

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