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Insurance Industry › Medicare › Settlement

King & Spalding

District Court Orders CVS Caremark to Pay U.S. Government $95 Million

King & Spalding on

On June 25, 2025, Chief Judge Mitchell S. Goldberg of the U.S. District Court for the Eastern District of Pennsylvania issued a ruling in the case of U.S. ex rel. Sarah Behnke v. CVS Caremark Corp. et al., ordering CVS...more

Epiq

How Plaintiff and Defense Attorneys Can Protect Beneficiaries’ Finances and Health Care in MMSEA Section 111 Reporting

Epiq on

Insufficient collaboration between plaintiff and defense attorneys regarding Medicare, Medicaid, and SCHIP Extension Act (MMSEA) Section 111 reporting requirements creates administrative complications which can negatively...more

Tyson & Mendes LLP

Shining Light on Phantom Medical Bills–Lessons from Washington on Using Federal Hospital Price Transparency Rules to Fight Back

Tyson & Mendes LLP on

How many of you reading this have had this experience: you get a settlement demand with hundreds of thousands of dollars in claimed hospital bills, but the actual amount owed by the claimant is redacted, or you are told by...more

Pillsbury - Policyholder Pulse blog

In Another Blow to the “Uninsurability” Defense, Court Holds that Settlement Labeled “Restitution” Is Insurable

Pillsbury - Policyholder Pulse blog on

In previous posts, we have emphasized the continued judicial trend rejecting insurer arguments that losses purportedly sounding in restitution or disgorgement are “uninsurable” under D&O policies. Despite that trend, insurers...more

Carlton Fields

Look, up in the sky! It’s a bird, it’s a plane, it’s… uh oh… a Super Lien!

Carlton Fields on

Liability insurers have always gnashed teeth over the dreaded “super lien” – aka a lien asserted by Medicare for treatment expenses where the patient is reimbursed through a settlement obtained in personal injury litigation....more

Carlton Fields

Justice Department Recovers Nearly $6 Billion From False Claims Act Cases in 2014

Carlton Fields on

The U.S. Department of Justice (DOJ) obtained a record $5.69 billion in settlements and judgments from civil cases involving fraud and false claims against the government in fiscal year 2014. This marks the first time the DOJ...more

Cranfill Sumner LLP

Adjusters: Best Practices for Dealing with Liens

Cranfill Sumner LLP on

In dealing with a workers’ compensation claim, adjusters will want to be sure to be aware of any other entities that may have a lien on money that might be awarded to the injured worker. In North Carolina workers’...more

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