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Medicare Insights

Through an integrated medical, pharmacy, claims and legal approach, we deliver insights to help navigate the ever‑changing Medicare Secondary Payer landscape.

Recent blog posts

June 23, 2022 · Medicare Insights Team
On June 6, 2022, the Supreme Court ruled 7-2 in Gallardo v. Marstiller that Florida Medicaid was permitted reimbursement from a settlement involving a permanently disabled woman. The woman, Ms. Gallardo, was involved in a catastrophic injury when she was hit by a truck while exiting a school bus. Florida Medicaid previously paid $862,688.77 in medical expenses and was expected to continue paying for future medical expenses related to this incident. Read more...
May 05, 2022 · Medicare Insights Team
The Centers for Medicare and Medicaid Services (CMS) held a webinar on April 13, 2022, to discuss their new initiative, Go Paperless.  Go Paperless provides Responsible Reporting Entities (RREs) the ability to receive Medicare correspondence digitally through the Medicare Secondary Payer Recovery Portal (MSPRP). Read more...
April 27, 2022 · Medicare Insights Team
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April 13, 2022 · Medicare Insights Team
On March 28, 2022, a Sixth District Court (Southern District of Ohio Eastern Division) issued an Opinion and Order holding that Medicare Advantage Organizations (MAOs) have a private right of action for double damages under 42 U.S.C. § 1395y(b)(3)(A). Read more...
April 07, 2022 · Medicare Insights Team
On Wednesday, April 13, 2022, the Centers for Medicare and Medicaid Services (CMS) will host an overview of the new “Go Paperless” feature available in the Medicare Secondary Payer Recovery Portal (MSPRP). Read more...
March 29, 2022 · Medicare Insights Team
On March 15, the Centers for Medicare and Medicaid Services (CMS) released an updated Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide (Version 3.6). Read more...
March 08, 2022 · Medicare Insights Team
On March 1, 2022, Centers for Medicare and Medicaid Services (CMS) submitted the following two Rules to the White House Office of Regulatory Information and Affairs (OIRA) for review and approval. Read more...
February 21, 2022 · Medicare Insights Team
In response to the most recent Workers’ Compensation Medicare Set Aside (WCMSA) Reference Guide, on February 17, 2022, The Centers for Medicare and Medicaid Services (CMS) hosted a webinar to provide a much-anticipated update on non-CMS-approved Medicare Set-Aside (MSA) products. CMS’ John Jenkins, Health Insurance Specialist, reviewed topics including Evidence-Based MSAs, Non-Submit MSAs and Compromise MSA. Read more...
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