42 CFR 411.24 - Recovery of conditional payments
| Cite as | 42 CFR 411.24 |
-
- This document is available in original version only for vLex customers
View this document and try vLex for 7 days - TRY VLEX
- This document is available in original version only for vLex customers
157 practice notes
-
Federal claims collection:
Interest rates on overdue debts,
...of the DCIA, the MSP provisions of the Medicare statute (section 1862(b) of the Social Security Act) and implementing regulations (42 CFR 411.24(m)) provide CMS separate, independent authority for assessing interest on delinquent MSP Comment: One commenter noted that proposed Sec. 30.24(b) ......
-
In re Dow Corning Corp., No. 95-20512.
...party payer must reimburse Medicare even though it has already reimbursed the beneficiary or other party." Id. at 5 n. 1 (quoting 42 C.F.R. § 411.24(i)(2)). The affirmative obligations that the MSPA places upon an entity such as the Debtor are discussed in greater detail below. Suffice it t......
-
Health Ins. Ass'n of America, Inc. v. Shalala, Nos. 92-5196
...Chevron U.S.A. v. Natural Resources Defense Council, 467 U.S. 837, 842-43, 844, 104 S.Ct. 2778, 2782, 81 L.Ed.2d 694 (1984). A. 42 CFR Sec. 411.24(e)--third-party administrator Both appellants are associations of health-insurance companies whose members often enter into contracts with emplo......
-
Aetna Life Ins. Co. v. Guerrera, CIVIL ACTION NO. 3:17-cv-621 (JCH)
...has a right of action to recover its payments from any entity, including a beneficiary, ... that has received a primary payment." 42 C.F.R. § 411.24(g). Aetna further cites the court to the government’s cause of action in the MSP, subsection (2)(B)(iii), which states that "the United States......
Request a trial to view additional results
125 cases
-
In re Dow Corning Corp., No. 95-20512.
...party payer must reimburse Medicare even though it has already reimbursed the beneficiary or other party." Id. at 5 n. 1 (quoting 42 C.F.R. § 411.24(i)(2)). The affirmative obligations that the MSPA places upon an entity such as the Debtor are discussed in greater detail below. Suffice it t......
-
Health Ins. Ass'n of America, Inc. v. Shalala, Nos. 92-5196
...Chevron U.S.A. v. Natural Resources Defense Council, 467 U.S. 837, 842-43, 844, 104 S.Ct. 2778, 2782, 81 L.Ed.2d 694 (1984). A. 42 CFR Sec. 411.24(e)--third-party administrator Both appellants are associations of health-insurance companies whose members often enter into contracts with emplo......
-
Aetna Life Ins. Co. v. Guerrera, CIVIL ACTION NO. 3:17-cv-621 (JCH)
...has a right of action to recover its payments from any entity, including a beneficiary, ... that has received a primary payment." 42 C.F.R. § 411.24(g). Aetna further cites the court to the government’s cause of action in the MSP, subsection (2)(B)(iii), which states that "the United States......
-
Cooper Hosp. Univ. Med. Ctr. v. Selective Ins. Co. of Am., A-46 September Term 2020
...insurers make payment to the provider, however, the provider must reimburse CMS for the amount that CMS paid. See ibid.; 42 C.F.R. §§ 411.22, 411.24.--------...
Request a trial to view additional results
14 firm's commentaries
-
Protecting The Interests Of Medicare Advantage Plans In Settlement Involving Plan Beneficiaries
...also establishes and defines a cause of action by the United States to recover from a primary plan. Id. § 1395y(b)(2)(B)(iii); see also 42 C.F.R. § 411.24 (describing a Government cause of action against a primary plan or any other person that received a primary payment). However, paragraph......
-
Medicare Secondary Payer A Lot Less Boring Now
...a beneficiary, provider, supplier, physician, attorney, State agency or private insurer that has received a primary payment." 42 C.F.R. §411.24(g) (emphasis added). Because the defendant lawyer and law firm allegedly "received a primary payment" when they cashed those settlem......
-
Medicare Secondary Payer – A Lot Less Boring Now
...a beneficiary, provider, supplier, physician, attorney, State agency or private insurer that has received a primary payment.” 42 C.F.R. §411.24(g) (emphasis added). Because the defendant lawyer and law firm allegedly “received a primary payment” when they cashed those settlement checks from......
-
Exploring Options for Conditional Payment Resolution
...that the primary payer has paid or will make, or in the case of a primary payment beneficiary, the amount of the primary payment.” 42 C.F.R. 411.24(c)(1). Section 411.37(d) of the regulations provides: “If Medicare payments equal or exceed the judgment or settlement amount, the recovery amo......
Request a trial to view additional results
10 books & journal articles
-
Vol. 7, No. 6, Pg. 20. Medicare Recovery in Liability Cases.
...of last resort), with Medicare having authority to recover directly from a Medicaid agency that has received a third party payment. 42 C.F.R. 411.24(j). There is no doubt that the statute and regulations create affirmative duties for beneficiaries, insurers and lawyers to protect Medicare's......
-
June 2006 - #2. PERMANENT TOTAL DISABILITY UNDER VERMONT WORKERS' COMPENSATION LAW.
...compensation act which equals such reduction." Medicare's subrogation interest is specified in 42 U.S.C. 1395y(B)(2)(b)(2000) and 42 C.F.R. 411.24 and 411.37(c)--(d) (2006). Medicaid's subrogation rights are codified in 42 U.S.C. 1396a(k) (2000). 42 C.F.R. 411.37. Interested parties may con......
-
71 The Alabama Lawyer 212 (2010). Navigating the Medicare Reporting Minefield- A Practitioner's Guide to Settlement with a Medicare Beneficiary.
...or 3. A private cause of action by CMS for double damages (twice the amount of Medicare's lien).See42 U.S.C. § 1395y(b)(2)(B); 42 C.F.R. §§ 411.24, These regulations only grant CMS the ability to recover double damages if it is required to take legal action to recover. The statute of limita......
-
Vol. 22, No. 1, 17. Workers' Compensation and Liability Lawyers Beware: Section 111 of the MMSEA Imposes Significant New Penalties for Failing to Protect Medicare's Interests.
...received a primary payment, including a beneficiary, provider, supplier, physician, attorney, state agency, or private insurer, see 42 C.F.R. § 411.24(g). Medicare also has a subrogation right, as well as rights of joinder and intervention. See 42 C.F.R. § In terms of repaying conditional p......
Request a trial to view additional results