Settlement News

2015 CMS Highlights

CMS started the year off with the issuance of a February 27, 2015, final rule establishing a right of appeal and formal Medicare Secondary Payer (MSP) appeal process for applicable plans. This process was mandated by Section 201 of the SMART Act. Applicable plans were defined as: liability insurance (including self-insurance), no-fault insurance, and workers’ […]

NuQuest Conditional Payment Department

The scope of conditional payment recovery has changed quite a bit since its inception. The Secondary Payer Compliance guidelines can not only include Medicare, but also Medicaid, Medicare Advantage Plans, and Government and Military Medical Plans. These agencies, now included in Secondary Payer Compliance, are creating subrogation departments or obtaining subrogation contractors to handle the […]

NuQuest consolidates with Protocols

NuQuest and Protocols are recognized leaders in the MSP Compliance industry. As long-standing, strategic partners, we have mutually agreed to join forces and consolidate our complementary strengths, expertise and operations into one organization under the NuQuest brand. “Our outstanding leadership team has done a fantastic job of building a solid and successful operation that provides […]

Section 111 Update

Author: Iliana A Gallegos, On October 6, 2014, the Centers for Medicare & Medicaid Services (CMS) revised the MMSEA Section 111 NGHP User Guide. Of note, version 4.3 of User Guide was updated to reflect the delay of ICD-10 diagnosis code implementation from October 2014 to 2015, pursuant to the Protecting Access to Medicare Act […]

Humana Insurance Company vs Farmers Texas County Mutual Insurance Company and Mid-Century Insurance Company of Texas

Humana Insurance Company vs Farmers Texas County Mutual Insurance Company and Mid-Century Insurance Company of Texas Cause No. 13-CV-611- LY, U. S. District Court for the Western District of Texas, Austin Division (filed September 24, 2014) The question presented in Humana Insurance Company v. Farmers Texas County Mutual Insurance Company and Mid-Century Insurance Company of […]

Raymand Nawas vs State Farm Mutual Automobile Insurance Company

Raymand Nawas vs State Farm Mutual Automobile Insurance Company No. 13-11158, U.S. District Court for the Eastern district of Michigan, Southern Division, 2014 U.S. Dist. 128365 Raymond Nawas v. State Farm Mutual Automobile Insurance Co., decided by the US. District Court for the Eastern District of Michigan on September 15, 2014, primarily involved a claim […]

Estate of Clinton McDonald vs Indemnity Insurance decision

Estate of Clinton McDonald vs Indemnity Insurance decision, Civil Action No. 3:12- CV-577 United States District Court for the Western District of Kentucky, 2014 U.S. Dist LEXIS 121902 The Estate of McDonald case involved the “ private cause of action” provision of the Medicare Secondary Payer Act (MSPA) 42 U.S.C. ss 1395 y(b)(3)(A). This provision […]