Insights Archives - Page 4 of 4

Feb 8, 2010

Insurers Plea to Health Secretary: Call Off April 1 MSP Deadline

A trio of insurance industry trade groups are pressing the Secretary of Health and Human Services to put off an April 1 start date for mandatory reporting of Medicare Secondary Payer (MSP) information, a program designed to reduce the likelihood of medical costs being shifted to the federal government. “Despite our best efforts and those […]

Jan 18, 2010

How Medicare Secondary Payer Law Works

The Medicare Secondary Payer law essentially allows the U.S. government to recover reimbursement from insurers and self-insured plans that are legally required to the primary source of payment of medical care for individuals eligible for Medicare who settle a liability claim According to the Code of Federal Regulations, 42 CFR 411.25, the parties also are […]

Jan 17, 2010

Medicare Gets Aggressive in Drive to Recoup Medical Costs

The U.S. government’s first-of-its-kind lawsuit against all parties that settled a pollution liability case signals Medicare’s aggressive push to make sure it does not pay medical expenses when others are to be the primary sources of payment, observers say. The suit filed Dec. 1, 2009, cites Medicare Secondary Payer provisions in federal law that allow […]

Dec 14, 2009

Secondary Payer Law Creates Challenges

Failure to comply with the Medicare, Medicaid and SCHIP Extension Act of 2007 and the Medicare Secondary Payer Act could be costly for all parties involved in litigation or claims filed by Medicare beneficiaries, says Iman Soliman, an attorney with law firm Bowman and Brooke L.L.P. in Phoenix. Those potentially affected should see the Centers […]

Dec 7, 2009

Deadline Looms for Firms to Register Claims Data

Insurers and self-insured employers face a Dec. 31 deadline to register with a federal agency, but numerous questions remain about what workers compensation and liability claims data must be fed into the Medicare system, several experts say. Insurers and self-insured employers identified as responsible reporting entities must register with the U.S. Centers for Medicare & […]

Nov 30, 2009

Some Comp Cost Increases Blamed on Medicare Rules

Inflated rulings on how much employers must set aside to ensure Medicare does not pay for workers compensation medical claims are resulting in needless cost increases, risk managers and claims experts contend. Claim settlement delays and government practices for evaluating workers comp claims requiring a Medicare set-aside are boosting costs for those claims by as […]

Oct 15, 2009

Municipalities and Medicare

Is a municipality immune from conditional payment liability under the Medicare Secondary Payer Act, 42 U.S.C. §1395y(b)(8)? No. This answer may surprise claims managers for public entities, but the law provides no protection whatsoever for municipalities. Not even federal government agencies are exempt. The rationale is simple: Medicare needs to be made whole. Social Security and […]

Oct 28, 2008

Navigating Medicare Secondary Payer Compliance

The Medicare Secondary Payer Act has been in place for more than two decades. During that time, much has been written regarding the requirements to comply with Medicare. Third-party administrators and self-insureds are particularly vulnerable to changes in Medicare regulations—most recently, and in particular, the State Children Health Insurance Program Extension Act. This article traces […]

Medicare Advocacy and Recovery Coalition