The Medicare Secondary Payer Compliance industry had an eventful 2016. Between Commercial Recovery Center’s (CRC) conditional payment recovery issues, CMS’ change in its process and then unchanging the process, Medicare Advantage Organization case law and more, there has been plenty to keep everyone engaged throughout the entire year. With a transition of the government in […]

The new administration has made the repeal of the Affordable Care Act (ACA) a priority item on their agenda. Under the ACA, many states had opted to expand Medicaid eligibility for certain individuals in order to provide insurance coverage. Although the transition to the new administration is still underway, a review of the backgrounds of […]

NuQuest’s expanded services now include access to a Medicare Secondary Payer (MSP) compliance legal team. Headed by Robert Sagrillo, President of NuQuest and Chief Legal Officer, the team assists our customers in evaluating their MSP obligations in settlements and works with them to facilitate optimal outcomes. Robert Sagrillo, JD, Chief Legal Officer and President of […]

Join Patrick Czuprinski, J.D., MSCC August 3rd at 1:00 pm CST for our webinar Register here presentation on Medicare Secondary Payer compliance issues in liability cases. He will address Section 111 reporting obligations as well as the numerous conditional payment reimbursement options in liability claims. The presentation will also examine the various factors that impact […]

In the United States there are two types of laws: state laws and federal laws. A state court generally interprets and applies state law to the facts of a claim and a federal court generally interprets and applies federal law. However, there are circumstances where a state court must use federal law in determining the […]

Opioid projections frequently make up a significant portion of a Medicare Set Aside (MSA). CMS projects the future drug component of the MSA by looking at the claimant’s current pharmacy usage and treatment records. The existing usage patterns generally account for CMS’ monthly drug projections for life. Given the growing body of evidence-based medicine studies […]

August 7th: Alabama Self-Insured, Destin, FL August 11th: Indiana Worker’s Compensation Institute, Indianapolis, IN August 11th: Workers Compensation Medical and Disability, San Diego, CA August 18th: Louisiana Business Industry, Baton Rouge, LA August 21st: Workers’ Compensation Institute Annual Conference, Orlando, FL August 25th: State Board Workers’ Compensation of Georgia, Atlanta, GA August 26th: KORT Annual […]

Although work-related injuries are generally pursued under the exclusive remedy offered through state workers’ compensation laws, certain injuries may also give rise to a common law action against a third party. These scenarios frequently involve injuries from motor vehicle accidents during work-related travel or from defective machinery used in the workplace. In recognition of this, […]

As we begin 2016, we expect CMS’ new final conditional payment recovery process to assist in expediting the settlement process for cases involving Medicare beneficiaries. We anticipate future litigation to arise regarding the definition of the “settlement date”. This year is also likely to see greater efforts by states to collect Medicaid liens from settlements. […]

By Rasa Fumagalli, J.D., MSCC The recent Michigan Circuit Court opinion in the John F. Hull v Home Depot USA, Inc. case (CN. 15-148344-CZ (2/17/2016)) has raised several issues in the area of MSP compliance. The Court was asked to rule on motions for summary disposition of Hull’s Private Cause of Action (PCA) case. Hull […]