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US District Court: Evaluates Requirement of Demonstrated Responsibility
Previously, we reported on the trend of recent decisions holding that a contractual relationship alone is insufficient to demonstrate...
Melisa Zwilling
May 12, 2016


US District Court: Involvement of MSPA Does Not Create a Federal Question
In Mikiewicz v. Hamorski and Erie Insurance Exchange, 2016 U.S. Dist. LEXIS 58859 (May 3, 2016), the United States District Court for the...
Melisa Zwilling
May 12, 2016


US District Court: CIGA Responsible for Reimbursing Medicare Conditional Payment Claims
In CIGA v. Burwell, 2016 U.S. Dist. LEXIS 34163 (March 16, 2016), the California Insurance Guaranty Association (CIGA) filed a...
Melisa Zwilling
May 12, 2016


Petitioner Alleges Violation of the False Claims Act By Making Medicare Primary Payer
In Negron v. Progressive Cas. Ins. Co.., No. 14-577, 2016 U.S. Dist. LEXIS 24994 (U.S Dist. N.J., March 1, 2016), a complaint was brought...
Melisa Zwilling
Mar 29, 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...
Melisa Zwilling
Mar 23, 2016


Hospital Must Exhaust Administrative Remedies Before Filing Suit in Federal Court
Select Specialty Hospital-Ann Arbor, the Plaintiff in the present action, filed suit in federal court against the Secretary of Health and...
Melisa Zwilling
Feb 16, 2016


Court Dismisses Takemoto Qui Tam Action
On January 20, 2016, the US District Court for the Western District of New York issued an order dismissing the claims of Kent Takemoto...
Melisa Zwilling
Jan 28, 2016


Determining Rights of Medicare Advantage Plans: State Lacks Jurisdiction
In the most recent decision in a series of cases involving a 2009 incident at a condominium, a Florida Court of Appeal finds that the...
Melisa Zwilling
Dec 10, 2015


US District Court: Requires More Than Contractual Obligation to Establish Primary Payer Responsibili
We continue to see courts acknowledging the rights of Medicare Advantage Organizations (MAOs) to pursue an action for recovery of...
Melisa Zwilling
Oct 12, 2015


District Court in the Eleventh Circuit Gives Humana a Private Cause of Action Under the MSP
Courts continue to follow the Third Circuit’s lead by finding that Medicare Advantage Organizations (MAO) have a private cause of action...
Melisa Zwilling
Mar 18, 2015
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