Insights Archives - Page 2 of 4

Aug 8, 2017

Making Good Better: How to Improve Medicare Part D

It is hard to imagine that in 2003, when Congress enacted the Medicare Modernization Act (MMA) and created the Medicare Prescription Drug Program (the “Part D” program), nobody really knew whether beneficiaries would actually sign up. Nor did Congress know whether, or how, the law would actually work. The CMS administrator at the time, Tom […]

Jul 29, 2016

The Current Background of Medicare Advantages and Part D Litigation

Medicare Advantage Plans (MAPs), also known as Medicare “Part C,” are private insurance plans that provide a Medicare beneficiary’s “Part A” and “Part B” benefits. A Medicare beneficiary can choose to enroll in a MAP rather than traditional Medicare. Part D plans provide benefits for a Medicare beneficiary’s prescription drugs. It is important to note that […]

Jul 3, 2016

David Farber on Medicare Secondary Payer Complexities

Listen to audio here.

Dec 31, 2013

CMS to Merge Two Conditional Payment Units in 2014

The U.S. Centers for Medicare and Medicaid Services will officially merge the Coordination of Benefits and Medicare Secondary Payer Recovery teams into a single unit, which should save workers’ compensation attorneys several phone calls a year on conditional payment issues. CMS announced on Dec. 23 that it will launch the Benefits Coordination and Recovery Center […]

Dec 27, 2013

CMS Rolls Out Proposed Appeals Process for Recovery Actions

The Centers for Medicare and Medicaid Services on Thursday announced plans to seek comments on proposed rules to implement the first appeals process for insurers and self-insured employers targeted for recovery actions in workers’ compensation, liability and no-fault settlements to meet the requirements of the Strengthening Medicare and Repaying Taxpayers (SMART) Act of 2012. CMS […]

Dec 16, 2013

Insurers Stress ‘Good-Faith’ Exception to CMS Reporting Penalties

The Centers for Medicare and Medicaid Studies is seeking proposals on how it should penalize insurers who violate the agency’s claim-reporting requirements, and payers are responding that the agency should not penalize insurers who are making a good-faith effort to send the agency their data. The Centers for Medicare and Medicaid Studies issued an advance […]

Aug 9, 2012

High Court Asked to Hear Medicare Secondary Payor Dispute

Law360, New York (August 09, 2012, 1:53 PM ET) — A Medicare patient injured in an automobile accident urged the Supreme Court on Tuesday to determine whether Medicare can recover its entire payment when a beneficiary settles a tort or other claim for a reduced amount, claiming it could change how Medicare patients pursue personal […]

Aug 7, 2012

Secondary Payer: Brief says Supreme Court Review Needed on Limits to Settlement Recovery Authority

The federal government overstepped its Medicare Secondary Payer Act authority when it sought recovery of all of its costs of caring for a Medicare beneficiary from that beneficiary’s third-party settlement, the beneficiary argued in a brief filed with the U.S. Supreme Court Aug. 7 (Hadden v. United States, U.S., No. 11-1197, reply brief filed 8/7/12). […]

Aug 15, 2011

Odd Allies in Medicare Fight

An imposing new obstacle is getting in the way of the nation’s personal-injury lawsuits. It has nothing to do with the merits of the cases, or how the courts are operating. The obstacle is Medicare, the federal health insurer for the elderly. Lawyers say the program is disrupting a countless number of their settlements. Court […]

Medicare Advocacy and Recovery Coalition