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Medicare Advantage Organizations (MAOs) Appeals

Rumberger | Kirk

Eleventh Circuit Finds Medicare Secondary Payer Act Not Preempted by Procedural Requirements

Rumberger | Kirk on

This past week, the United States Court of Appeals for the Eleventh Circuit held that private causes of action brought under the Medicare Secondary Payer Act (MSP Act) are not preempted by contractual and state procedural...more

Bass, Berry & Sims PLC

The ABCs of Medicare and Medicaid Claims Audits: Responding to Audits and Potential Consequences from Negative Audits

Bass, Berry & Sims PLC on

As addressed in the first installment of this three-part series, healthcare providers face potential audits from an increasing number of Medicare and Medicaid contractors. Failing to respond properly can lead to significant...more

Bradley Arant Boult Cummings LLP

D.C. Circuit Ruling Escalates False Claims Act Risk for Medicare Advantage Organizations

In a ruling that may portend a significant uptick in False Claims Act (FCA) whistleblower cases, last week the U.S. Court of Appeals for the District of Columbia Circuit reversed a 2018 decision that vacated Medicare's...more

ArentFox Schiff

11th Circuit Upholds Rights of Medicare Advantage ‘Downstream Actors’ to File Suit under the Medicare Secondary Payer Act

ArentFox Schiff on

Calling it a “straightforward inquiry,” the US Court of Appeals for the 11th Circuit recently opted to expand access to the Medicare Secondary Payer Act (the MSP Act) private right of recovery to Medicare Advantage...more

Stoel Rives - Health Law Insider®

Medicare Advantage Premiums Are Not Subject to Washington Tax

Appeals Court ruling supports MA organization request for refund of B&O taxes paid on premiums - On April 1, 2019, the Washington Court of Appeals Division 1 ruled unanimously in a published opinion that premiums received by...more

Sheppard Mullin Richter & Hampton LLP

Blog Series Part 3: CMS Proposed Rule on Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug...

Medicare Advantage and Part D Preclusion List - The proposed rule issued November 1, 2018 (the “Proposed Rule”) by the Centers for Medicare and Medicaid Services (“CMS”) includes a number of regulatory changes to the...more

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