Understanding the MSPRC Process
Learn more about the Medicare recovery process under the MSP.
CUTTING EDGE INDUSTRY THOUGHT LEADERSHIP INSIGHTS
Synergy’s blog brings you the industry’s foremost thought leadership InSights on matters of healthcare lien resolution and Medicare Secondary Payer Compliance. Visit often to discover helpful InSights on important lien resolution compliance issues.
US Congress Passes the Strengthening Medicare Secondary Payer Rules Act: Will it Help?
On December the 19th the Strengthening Medicare Secondary Payer Rules Act was passed by the House. The Senate passed the Act on December the 21st. It is on its way to President Obama to sign. While it modifies the Medicare Secondary Payer Act, it only streamlines the MSP conditional payment process and has nothing to do with Medicare Set Asides.
ERISA: Put New Teeth Into Plan Document Requests with 1024(b)(4)
One of the keys to properly defending against an asserted subrogation or reimbursement claim from an ERISA plan is making requests to the plan administrator. One of the major responsibilities of the plan administrator, as to dealing with the providing of information to beneficiaries, is contained in 29 U.S.C. 1024(b)(4).
From Roger Baron: 8th Circuit Exonerates Law Firm Doggedly Pursued for Liability on ERISA Reimbursement Claim
Reprinted with permission from Roger Baron
The 8th Circuit Court of Appeals handed down its decision in Treasurer, Trustees of Drury Industries v. Sean Goding, No. 11-2885. This is a situation where the ERISA plan doggedly pursued the law firm which had represented the ERISA beneficiary in securing a tort recovery.
ERISA Liens: How to turn the McCutchen gray into green for your client
The uncertainty that exists regarding a self-funded ERISA plan’s ability to refuse reduction of their claim based upon equitable principles can be used to increase your client’s net recovery. A gray area was created in ERSIA healthcare subrogation and reimbursement rights by the 11th Circuit’s April 2010 ruling in Zurich American Insurance Co. v. O’Hara.
From Roger Baron: “unclean hands” is equitable defense to claim under ERISA § 1132(a)(3) according to Oregon Federal Court
In Ayers v. LINA, No. 6:08-cv-06287-AA, (D.Or. April 19, 2012), the court was adjudicating a dispute over LTD benefits under ERISA coverage. The court held “LINA cannot recover any overpaid amounts pursuant to 1132(a)(3) if Ayers can demonstrate that it was acting with unclean hands.” As to whether or not “unclean hands” exists, the court holds that there is a “genuine issue of material fact,” overruling both parties’ motions for summary judgment on the counterclaim.
Outsourcing of Lien Resolution – The Florida Supreme Court’s Ruling on 4-1.5
On April 12th, the Florida Supreme Court ruled on the proposed amendment to rule 4-1.5 and rejected it. What does this mean for lien resolution outsourcing?
Is your MSP compliance provider doing more harm than good by advocating to ignore Medicare’s future interests?
With Medicare Secondary Payer (“MSP”) Compliance on everyone’s minds these days, it is no wonder that MSP vendors have tried to capitalize on these fears by offering services targeting them. The problem is that some of these vendors may be doing more harm than good.