Casualty Solutions

8/10/2023 - 20 min read

United States District Court for Massachusetts rules that a MAP assignee has standing

New Medicare Advantage recovery case, the US District Court for MA in MSP Recovery Claims Series 44, LLC v. Bunker Hill Insurance Company, 2023 WL 4744739 two questions

8/9/2023 - 19 min read

Closing TPLF “data gaps” – recently discussed options and considerations

Whether parties using TPLF should be required to disclose the TPLF agreement to the opposing party as part of claims litigation continues to be a hotly debated topic.

7/24/2023 - 4 min read

Reminder update: Idaho transitions to Release 3.1

Reminder that the Idaho Industrial Commission (IIC) will transition from Electronic Data Interchange (EDI) Claims R3.0 (FROI and SROI) to EDI Claims R3.1

6/28/2023 - 10 min read

Mid-Year “Round-Up” 2023 – keeping track of Medicare and other claims updates (ICYMI)

We are at the mid-point for 2023! It has been a busy year in so many claims areas. Time to regroup on the key claims updates over the past months – ICYMI style!

6/23/2023 - 22 min read

Governor Edwards vetoes Louisiana’s proposed Third-Party Litigation Funding (TPLF) disclosure bill

S.B. 196, as outlined more fully below, called for the disclosure of (TPLF), referred to as “litigation financing agreements” in the bill, in civil actions.

6/9/2023 - 7 min read

Indiana enacts statutory provision regarding third-party litigation funding (TPLF) disclosure

On April 20, 2023, Indiana Governor Eric Holcomb (R) signed into law Indiana House Bill 1124 which adds a third-party litigation funding (TPLF)

6/9/2023 - 48 min read

Several industry groups renew calls for a mandatory TPLF disclosure rule as part of the Federal Civil Rules of Procedure

6/7/2023 - 11 min read

CMS holds webinar to discuss the Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File “opt-in” feature (starts July 2023) and other Section 111 items

(CMS) held a webinar where the agency discussed its upcoming Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File “opt-in” feature (starts July 2023)

6/7/2023 - 20 min read

CMS releases Section 111 NGHP User Guide (Version 7.2, June 5, 2023) – new changes include: NGHP Unsolicited Response File, ORM reporting trigger, ORM termination, and HEW software

(CMS) has released an updated Section 111 NGHP User Guide regarding Section 111 reporting related to non-group health plans.

6/7/2023 - 8 min read

The RAMP Act is re-introduced in Congress – bill proposes revisions to the MSP’s private cause of action (“double damages”) provision

On 5/16/23, (RAMP) Act was re-introduced into the U.S. House of Representatives, bill proposes revisions to the MSP’s private cause of action provision.

5/24/2023 - 13 min read

The Highway Accident Fairness Act of 2023 (H.R. 2936) is introduced into Congress – bill prohibits staged accidents with commercial vehicles and includes TPLF disclosure provisions

In general, H.R. 2936 would amend title 49, United States Code, to “prohibit staged collisions with commercial motor vehicles, and for other purposes.”

Gavel on a white background with a small shadow.

5/23/2023 - 9 min read

The United States District Court for Massachusetts dismisses a Medicare Advantage claim for “double damages” – rules that insurer’s Section 111 reporting does not establish standing to sue

The U.S. District Court for Massachusetts dismisses Medicare Advantage claim for “double damages”—rules insurer’s Section 111 reporting doesn't establish standing to sue.

5/18/2023 - 4 min read

CMS releases the WCMSA Reference Guide Version 3.9

CMS has made various updates to different aspects of its WCMSA process, including removing the time limit on Amended Reviews.

5/16/2023 - 16 min read

Harnessing AI and ML through Discovery Navigator to save time and money on medical records review

Understand the vital role of AI in automating record reviews and how it addresses current industry challenges.

5/3/2023 - 6 min read

CMS releases Non-Group Health Plan (NGHP) Applicable Plan Appeals Reference Guide (Version 1.0)

The Centers for Medicare and Medicaid Services (CMS) has released a Non-Group Health Plan (NGHP) Applicable Appeals Reference Guide (Version 1.0, April 27, 2023).