Wednesday, July 24, 2013

MA: New offensive move by Humana

Franco Signor reports that Humana, which operates Medicare Advantage plans in numerous states, has filed separate lawsuits in Federal courts in four states, seeking a declaratory judgment from the courts regarding their MA plans' rights of reimbursement and the extent to which their rights coincide with those of CMS under ordinary Medicare. One of the cases is Cariten Health Plan, Inc. v. Mid-Century Insurance Company, filed in the Eastern District of Tennessee, Knoxville Division. (Cariten is affiliated with Humana Group.) Since Tennessee is within the Sixth Circuit, this portends a challenge to the Care Choices case which is controlling authority in this Circuit.

For those with PACER access, the docket number in that court is 3:13-cv-00417. The Complaint was filed on July 17. 

Wednesday, July 17, 2013

Portal regulations expected in October

CMS has announced that an interim final rule on the Medicare Secondary Payer Recovery Portal is expected to be issued in October 2013. This advance notice of its plan to issue an interim final rule (not to be confused with an Advance Notice of Proposed Rulemaking) may be found here.
(Acknowledgements: MARC and Franco Signor)