Waste and Fraud in Medical Care

• 09/09/15
• Judge David Langham

We hear about the occasional over-billing in the medical system. Significant time is dedicated in the press to individuals who either perceived or convicted of gaming systems designed for delivery of medical ...
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More Medicare Secondary Payer Private Cause of Action “Action”

• 09/02/15
• Heather Schwartz Sanderson

A new opinion was just released out of the U.S. District Court for the Southern District of Florida, MSPA Claims 1, LLC v. IDS Property Casualty Insurance Company (August 28, 2015). This case involved MSPA ...
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The New Commercial Repayment Center: Important Information from CMS’ Webinar and Update on Conditional Payment Recoveries

• 08/27/15
• Heather Schwartz Sanderson

On Tuesday, August 23rd, CMS held a webinar on the transition for Non-Group Health Plans (NGHP) to the Commercial Repayment Center (CRC). A summary follows on how work will be coordinated between the CRC and ...
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E-FORCSE and KASPER Cousins with a Cause

• 08/26/15
• Judge David Langham

Since 2009, Florida has had a prescription drug monitoring program, or "PDMP." It is called E-FORCSE (Electronic-Florida Online Reporting of Controlled Substance Evaluation Program). The ...
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If Workers Compensation Were Nationalized

• 08/12/15
• Judge David Langham

In 1972, the Report of the National Commission on State Workmen's Compensation Laws was published. This link leads to a page that provides access to the various portions of the report, There are ...
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CMS Alert Reminds the Industry Regarding Escalation of Debt to the Treasury Department

• 08/07/15
• Heather Schwartz Sanderson

CMS issued an alert on August 5th which states the following: On May 9, 2014, the President signed into law the Digital Accountability and Transparency Act (DATA Act). One outcome of this legislation will ...
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Is is time for that bake sale, or are there other solutions

• 08/05/15
• Judge David Langham

In June 2014 I penned The First Social Program Bankruptcy is Upon Us. The math in that analysis interested me. The Social Security Disability program is consuming about $12.4 billion per month, or ...
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MSP Medicare Advantage Plan Recovery Rights Case Law Rampant

• 08/03/15
• Heather Schwartz Sanderson

The Medicare Advantage Plan (MAP) system continues to grow; according to the Kaiser Family Foundation, as much as 31% of the Medicare population in the United States is also enrolled in a Medicare Advantage ...
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Measuring Marijuana Impairment

• 07/24/15
• Judge David Langham

The Colorado Supreme Court decision in Coats v. DISH answered some marijuana issues, but left some unanswered questions. The primary one that marijuana states will have to address is likely ...
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