Firm News

An updated Worker’s Compensation Medicare Set-Aside (“WCMSA”) reference guide has been issued.[1] The revised guide includes: Fields formerly labeled as “HICN” have been labeled as “Medicare ID” and can accept either Health Insurance Claim Number (“HICN”) or the new Medicare Beneficiary Identifier; The link to the CDC Life Expectancy Table has been updated; and The...Read More

On August 16, 2018, the US Court of Appeals for the Sixth Circuit remanded Duncan v. Liberty Mut. Ins. Co., 2018 U.S. App. LEXIS 22811, back to the US District Court. The case involved the Medicare Secondary Payer Act (MSPA) and questioned whether a party can pursue double damages under the Act. Facts of the...Read More

Two recent legal decisions out of the Eleventh Judicial Circuit in and for Miami Dade County indicate that Medicare Advantage Organizations (MAOs) may be able to obtain reimbursement from no-fault liability carriers pursuant to Medicare Secondary Payer law on a class-wide basis. On April 20, 2017, the Honorable Judge Antonio Arzola entered a 56-page order...Read More

After several wins at the U.S. Court of Appeals for the 11th Circuit, MSP Recovery made history again obtaining class certification for Medicare Advantage Organizations based on the principles of Medicare Secondary Payer law, against IDS Insurance Company. On April 20, 2017, the Honorable Judge Antonio Arzola entered a 56-page Order Granting the Motion to...Read More

Lawyers: 11th Circuit Medicare Ruling Could Be Worth Billions by Katheryn Hayes Tucker A federal appeals court decision analyzing the Medicare Secondary Payer Act could put the nation’s largest automobile insur­ance companies and other providers on the hook to pay billions of dollars in Medicare reimbursement. “This is a humongous victory,” said John Ruiz of...Read More

11th Circuit Puts Insurers on the Hook to Repay Billions Eleventh Circuit Court Rules Again in Favor of Medicare Advantage Plans: Contract of Insurance Demonstrates Responsibility to Pay Eleventh Circuit Finds Mere Existence Of Insurance Contract Satisfies Condition Precedent To Action For Double Damages Under The Medicare Secondary Payer ActRead More

The Eleventh Circuit Court of Appeals follows the Third Circuit’s lead by finding a Medicare Advantage Organization (MAO) has a private cause of action to pursue reimbursement under the Medicare Secondary Payer Act (MSP). A case of first impression, Humana Med. Plan v. W. Heritage Ins. Co., touched upon whether the MSP private cause of...Read More

Insurance company IDS’ attempt to stop MSP’s class action from moving forward is denied by the appellate court requiring a face off between IDS and MSP in less than 30 days where insurer is exposed to millions in repayment. On Monday, August 1st, 2016, MSP Recovery Law Firm secured an appellate victory as the Third...Read More

It should be of no surprise defendants prefer federal courts. Favorable procedural rules, offers of judgment, and unavailability of interlocutory appeals are just some of the reasons why defendants would conclude that a federal court in essence affords them a “home field advantage.” As a result, defense attorneys tirelessly seek removal. In a massive attack...Read More

On Tuesday, June 28, 2016, MSP Recovery Law Firm won a major victory for Medicare Advantage Organizations (“MAO”). In MSP v. Ocean Harbor, the Honorable Judge Samantha Ruiz-Cohen denied an auto insurer’s (“Defendant”) attempt to dismiss an MAO’s (“Plaintiff”) suit. The court held that the MAO clearly established that Florida state court had jurisdiction to...Read More

Suppose Joe is sixty-nine (69) years old, and while driving down I-95, another vehicle suddenly rear-ends him. Joe has Personal Injury Protection (“PIP”) coverage as part of his automobile insurance, but also an enrollee of a Medicare Advantage (“MA”) health plan offered by a Medicare Advantage Organization (“MAO”). Joe goes to the hospital as a...Read More

Court agrees with MSP Recovery on demonstrated responsibility and further strengthens a Medicare Advantage Organization’s (“MAO”) ability to recover monies. On June 24, 2015, the U.S. District Court, Southern District of Florida, ruled in MSP Recovery’s favor in the case styled “MSP Recovery, LLC v. Allstate Insurance Company”. The claim arose from a motor vehicle...Read More