CMS to Host Webinar to Discuss CRC ORM Recovery Issues
CMS recently announced that they are hosting a webinar to discuss issues with CRC’s recovery of conditional payment claims in cases...
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Melisa Zwilling
Apr 6, 2018
District Court Affirms Medicare Advantage Organization’s Right to Sue Primary Plans Pursuant to the
A U.S. District Court followed the trend of permitting a Medicare Advantage Organization (“MAO”) to sue pursuant to the Medicare...
Melisa Zwilling
Feb 27, 2018
UPDATE: Eleventh Circuit Court of Appeals Upholds District Court Decision Giving Medicare Advantage
As you will recall, in August 2016, the United States Court of Appeals for the Eleventh Circuit, following the lead of the Third...
Melisa Zwilling
Sep 26, 2017
State Court Refuses to Reduce Plaintiff's Economic Damages Award Due to Medicare's Subrogati
William Ashmore presented to Hartford Hospital for a non-emergency, planned procedure. It was during his hospital stay that he passed...
Melisa Zwilling
May 23, 2017
New Developments In The Case Of CIGA v. Burwell
In January 2017, we posted an article concerning a recent case, Cali. Ins. Guar. Ass’n v. Burwell, No. 2:15-cv-01113-ODW (FFMx), 2017...
Melisa Zwilling
Apr 27, 2017
U.S. District Court Upholds Dismissal of Claim Brought Under the Private Cause of Action Provision o
In the present case, Claims v. Co. V., No. 16-20338-CIV-LENARD/GOODMAN, 2017 U.S. Dist. Ct. LEXIS 43755, the Plaintiff (MSPA Claims 1,...
Melisa Zwilling
Jan 26, 2017
ALERT: District Court Finds CMS Erred in Requiring Carrier to Reimburse Entire Provider Charge Rathe
It is a familiar story for many insurance carriers and self-insured employers—Medicare has asserted a number of conditional payment...
Melisa Zwilling
Nov 15, 2016
District Court Grants Motion to Dismiss After U.S. Argues that Court Lacks Jurisdiction Over Medicar
In Cheryl Nelson & Geico Gen. Ins. Co. v. Medi-Cal., No. 1:16-cv-01328-LJO-BAM, 2016 U.S. Dist. Ct. LEXIS 153596 (E.D. Cal., November 4,...
Melisa Zwilling
Sep 21, 2016
Alert! Eleventh Circuit: Contractual Obligation Sufficient to Establish “Demonstrated Responsibility
What qualifies as a “demonstrated responsibility” sufficient to proceed under the private cause of action provision of the Medicare...
Melisa Zwilling
Mar 23, 2016
US District Court: Plaintiff Responsible for Full Amount of Formal Demand
In Anderson v. Burwell, 2016 U.S. Dist. LEXIS 26633 (March 3, 2016), a case arising out of the United States District Court for the...
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