Announcement of Centers for Medicare and Medicaid Services (CMS)'s Final Rule on civil money penalties for failure to properly report claims of Medicare beneficiaries.
PAID Act should significantly reduce number of post-settlement demands for reimbursement from Medicare Part C and Part D providers
Nationwide reimbursement litigation by private Medicare Advantage Plans (MAPs) providing health coverage to some Medicare enrollees has grown significantly over the past few years. Any number of entities are sued for failing to reimburse MAPs for injury-related treatment costs when a beneficiary is paid to resolve a claim. These include alleged tortfeasors, their insurers, tort plaintiffs, and their attorneys. Determining if a claimant receives health coverage under Medicare that paid a claimant’s medical expenses related to an injury is critical to complete claim ...
The U. S. Court of Appeals for the Third Circuit found private health insurers could seek double damages in federal court under the Medicare Secondary Payer Act. In re Avandia Marketing, Sales Practices and Products Liability Litigation, 685 F.3d 353 (3d Cir. 2012) is believed to be the first appellate case to reach this holding. The Court’s reasoning has been adopted by other circuits in similar cases. This case has significant implications for defendants and their insurers who settle cases or pay judgments involving Medicare Part C beneficiaries. Precautions employed to ...
