Medicare Advocacy and Recovery Coalition

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 […]

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 […]

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 & […]

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 […]

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 […]

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 […]