Legislative / Case Law
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Medicare Advantage Plan’s Conditional Payments Limited by New York Laws
by P. Czuprynski In Claims v. Merchs. Mut. Ins. Co.[1], the Court partially denied Medicare Advantage Plan’s suit over conditional payment reimbursements and highlights a possible defense for carrier/self-insureds to...
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FL Court of Appeal Reverses Class Certification by MSP Recovery for a Third Time
by M. Heberling We have previously written about the challenges MSP Recovery and their subsidiaries have experienced when trying to effectively navigate state procedural requirements and properly establish a claim...
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Settlement Enforced Despite Dispute on Medicare and Medical Lien Terms
by P. Czuprynski In Smith v. Wal-Mart Stores E., LP.[1], a claimant filed a complaint alleging that Wal-Mart and Vestis Services was negligent, resulting in a slip and fall. The...
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A Cautionary Tale: Cabezas v. Penske Truck Leasing Co.
by B. Smith When it comes to disputes regarding the resolution of conditional liens as part of settlement, the courts will usually defer to settlement terms as their guide. This...
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Magistrate Denies Conditional Payment Reimbursement Request by MAP Plan
by P. Czuprynski In Series v. State Farm Mut. Auto. Ins. Co., 1:23 CV 22982 (July 15, 2025), the Magistrate Judge agreed that Series’ suit for conditional payment reimbursement should...
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Recent Legislative Changes Impacting Mental Health Coverage for First Responders Injured at Work
by K. Kline When we think about workers’ compensation, we often think of cases involving bodily injury claims – traumatic physical injuries, occupational exposure, and similar examples immediately come to...
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IIGF is Not a Primary Payer Under the Medicare Secondary Payer Act
by P. Czuprynski In IIGF v. Becerra[1] the United States District court for the Northern District of Illinois determined conditional payments alleged by Medicare, did not require reimbursement by IIGF...
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Understanding Medicare’s Three-Year Dates of Service Limitation
by P. Czuprynski The Medicare Secondary Payer Act requires reimbursement from an insurer or self-insured entity associated with a workers’ compensation, or a liability claim when there is (1) reasonable...
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Chevron Deference Overturned: Potential Impacts on MSP Compliance
by B. Smith and P. Czuprynski In Loper Bright Enterprises v. Raimondo, 2024 U.S. LEXIS 2882, the United States Supreme Court overturned the way courts were ordered to view federal...