An Arizona Federal District court finds PacifiCare of Arizona, a Medicare Advantage plan (Part C), does not have a private cause of action to recover payments it made on behalf of an injury victim...
In Alcorn, a federal district court refused the plaintiff’s attempt to bring in CMS to determine the amount of a potential conditional payment obligation prior to a settlement, judgment or award.
The Benson v. Sebelius decision reaches a result opposite to Bradley because medical expenses were claimed in the wrongful death action on behalf of the survivors instead of the estate.
The ABA house of delegates, during its 2011 mid-year meeting, adopted a resolution regarding Medicare Set Asides and reform of the Medicare Secondary Payer Act. It is the same old thing though,...
When a Medicare Set Aside is implemented, there are different options as far as how they are administered. The injury victim can self administer the set aside. In the alternative, a professional...
Upcoming seminar on Medicare Secondary Payer compliance and I will be presenting.
This is an interesting case as it was brought under 42 U.S.C. § 1983. A Nebraska court used the Ahlborn reduction approach finding Nebraska Dept of Health and Human Services was only entitled to...
A Florida Circuit Court Follows Ahlbornand significantly reduces Medicaid Lien
Medicare’s administrative procedures regarding conditional payments must be exhausted before bringing suit against Medicare. A federal district court lacks subject matter jurisdiction to determine...
Defendant’s may try to use liability set aside allocations to limit the injury victim’s damages.