CLM Magazine: Mapping Out a Course

In an article for CLM Magazine, MARC Coalition’s Heather Sanderson urges primary plans to consider best practices as courts rule in favor of Medicare Advantage Plans (MAP) recovering double damages. Sanderson astutely notes that with both the 3rd and 11th Circuit Courts finding in favor of MAPs being allowed to bring an Medicare Secondary Payer (MSP) private cause of action for double damages, industry is seeing “widespread” application of the double damages across the country. “The ease with which courts have determined a MAP can allege a sufficient double-damages MSP private cause of action claim is alarming,” writes Sanderson. “A recent district court case out of Illinois found that, for a MAP to allege an MSP private cause of action, it simply needs to allege that there is no genuine issue of material fact regarding the defendant’s status as a primary plan, the defendant’s failure to provide for primary payment or appropriate reimbursement, and the damages amount.”

The article in its entirely can be read here.

Featured News

  • Medicare Advocacy Recovery Coalition (MARC) Urges Beneficiaries to Support Legislative Reforms to Improve Medicare Secondary Payer (MSP) Program

    WASHINGTON, DC – February 22, 2023 – Established in 2008 with a mission to improve the Medicare Secondary Payer (MSP) program, the Medicare Advocacy Recovery Coalition (MARC) has unveiled a new website aimed at improving their critically important work.

    Read Article
  • The PAID Act is Now the Law

    The Medicare Advocacy Recovery Coalition (MARC) thanks the Congress for passing the PAID Act (H.R. 1375, Section 1301 of H.R. 8900) on December 11, 2020.  The bill was brought to the House Floor and passed by voice vote on December 8, 2020. 

    Read Article
  • Growing Number of Organizations Urge Congressional Support for the Paid Act

    In a letter addressed to Senators Tim Scott (R-SC) and Ben Cardin (D-MD), seventeen organizations and companies representing the Medicare Secondary Payer-regulated community urged Congress to pass the bipartisan Provide Accurate Information Directly (PAID) Act (S.1989/H.R.1375).

    Read Article