Is Uniformity on Its Way for Medicare Advantage Plans (MAP) Seeking Medicare Secondary Payer (MSP) Recovery?

As we have previously written, primary plans have been the subject of lawsuits by Medicare Advantage Plans (MAPs), Part D providers and Medicaid seeking double damages for the reimbursement of conditional payments.  Several courts of appeal have addressed this issue regarding standing to bring such ...
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6th Circuit Court of Appeals Limits a MSP Private Cause of Action

 6th Circuit Court of Appeals Limits a MSP Private Cause of Action The U.S. Circuit Court of Appeals handles appeals from U. S. District Courts in Tennessee, Ohio, Kentucky and Michigan.  A recent ruling by this court, affirming a district court opinion dismissing a claim ...
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CMS’ New WCRC Transition and How It Affects You

On September 1, 2017, CMS awarded a new contract to Capitol Bridge, LLC, an Arlington, VA company, for the Workers' Compensation Review Contractor (WCRC).  The purpose of this contractor arrangement is to independently price the future Medicare-covered medical treatment and costs, including prescription drugs, related ...
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The Frustrating World of Conditional Payments

By: Ben Pugh, Esquire Medicare currently uses two contractors to collect conditional payments, the Commercial Repayment Center (CRC) and the Benefits Coordination and Recovery Center (BCRC).  The typical situation involves one of these contractors insisting on reimbursement for an item that is not related to ...
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The Passing of the Baton: MSP Commercial Repayment Center Contractor Transition

By Patricia Rapson, RN, CCM, CNLCP®, CLCP, LNCC, MSCC      Director of Clinical Services Today change is in the air as Performant Recovery, Inc. prepares to take the helm as the new MSP Commercial Repayment Center Contractor with CMS. Town Hall presentations were held via ...
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