The Cleveland Metropolitan Bar Association’s 28th Annual Health Care Law Institute commences on Friday, April 27, 2012. DULAC, Inc., is pleased to be an exhibitor and to have the opportunity to be a sponsor of this program. We will also be an exhibitor at the CMBA seminar “Introduction to Health Care Law” on Thursday, April [...]

We are pleased to be a Sponsor of the 28th Annual Health Care Law Institute of the Cleveland Metropolitan Bar Association (CMBA). The seminar begins on the afternoon of April 26, 2012 with presentations on “Introduction to Health Care Law”. The full day program continues on April 27, 2012 with the Health Care Law Institute. [...]

The January 2012 newsletter of the National Practitioner Data Bank contains detailed information on upgraded reporting features. These features will streamline medical malpractice claims reporting protocols. In particular, the NPDB is in the process of implementing an electronic protocol for filing NPDB reports with the related state licensing entity. The NPDB advises that, One of [...]

CMS has published a quick reference guide for MMSEA Section 111 Reporting. The Guide is specifically furnished for Non-Group Health Plan (NGHP) Responsible Reporting Entities (RRE). The full document is located at: https://www.cms.gov/MandatoryInsRep/Downloads/NGHPQuickRef.pdf Our solution to the logistical and substantive challenges of MMSEA Section 111 features complete reporting service. Our resources will extract and review [...]

The Office of Public Information of the Supreme Court of Ohio published the following release on December 8, 2011: “Court Rules Expert Testimony Needed to Show Undisclosed Medical Risk Actually Caused Injury Where Patient Claims ‘Lack of Informed Consent’ to Medical Procedure Please note: Opinion summaries are prepared by the Office of Public Information for [...]

DULAC, Inc. is pleased to be an advertising sponsor of the Bar Journal of the Cleveland Metropolitan Bar Association. The November, 2011, issue features articles by various authors on class actions, federal pleading standards, and an introduction to the newly-formed Insurance Law Section. The latter is particularly apropos given the adoption by the Supreme Court [...]

We are pleased to be an advertising sponsor of the Bar Journal of the Cleveland Metropolitan Bar Association, October 2011 edition. We feature links to our complete MMSEA Section 111 reporting services. This is a topic of current urgency as the Centers for Medicare and Medicaid Services (CMS) advised that Section 111 reporting on liability [...]

MMSEA Section 111 reporting remains a significant logistical and substantive issue for liability insurers. CMS published a series of Alerts on Friday, September 30, 2011, immediately prior to the commencement of the existing timeline pertaining to reporting of liability claim Total Payment Obligation to the Claimant (TPOC). Perhaps the Alert of the most significant general [...]

The September, 2011 issue of the Bar Journal of the Cleveland Metropolitan Bar Association has been published. Once again, we are pleased to be an advertising sponsor of this excellent publication and organization. Our solution to the logistical and substantive challenges of MMSEA Section 111 features complete reporting service. Our resources will extract and review necessary [...]

We are pleased to be an advertising sponsor of the Annual Meeting edition (July/August, 2011) of the Journal of the Cleveland Metropolitan Bar Association.  We feature our complete MMSEA Section 111 reporting services as well as medical malpractice claims administration. Our solution to the logistical and substantive challenges of MMSEA Section 111  features complete reporting service.  Our [...]

Our continued discussion addresses areas of ancillary risk exposure that result from incorrect MMSEA Section 111 reports, above and beyond the Civil fines and penalties.   Even though the RRE has the nexus with the agency as far as the obligation to file reports, we nevertheless see that there is privity in essence between the RRE and [...]

The Centers for Medicare and Medicaid Services (CMS) website indicates the scheduling of Town Hall Teleconferences for MMSEA Section 111 reporting as follows: August 24, 2011  NGHP Policy September 21, 2011 NGHP Technical October 19, 2011  NGHP Policy The website also has the schedule for GHP teleconferences. Our solution to the logistical and substantive challenges of [...]

The purpose of MMSEA Section 111 reporting is to assist with the collection of information that the  Coordination of Benefits Recovery Contractor (COBRC) will use to determine primary versus secondary payer status of Medicare in situations of payments made to Medicare beneficiaries by Applicable Plans, otherwise defined as Responsible Reporting Entities (RRE).  The reporting requirements are in addition [...]

The MMSEA Section 111 Reporting Agent Educational Forum, a LinkedIn group we established on October 9, 2009, has now reached a membership of 250. We  founded the group to facilitate dialogue on the substantive and logistical aspects of the MMSEA Section 111 reporting obligations, which are quite complex and subtle.  We are most appreciative of [...]

In order to comply with the mandates of Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), it is necessary for organizations that are subject to the Mandatory Insurer Requirements (MIR) to determine the manner in which the logistical aspects of reporting will be fulfilled.  An “Applicable Plan” of insurance (including [...]

During the CMS Town Hall Teleconference on June 29, 2011, discussing MMSEA Section 111 Reporting, a CMS representative advised that there is not any more information forthcoming to aid Ohio self-insured employers participating in the “15K Plan”.  Specifically, a concern was expressed to CMS about difficulties encountered by such employers with regard to determination of Medicare beneficiary [...]

Medicare Set-Aside Arrangements (MSA) and the reporting requirements of Section 111 of the Medicare, Medicaid, & SCHIP Extension Act of 2007 (MMSEA) are important elements of the Medicare Secondary Payer Statute as the Centers for Medicare and Medicaid Services (CMS) endeavors to achieve the long-term financial viability of the Medicare system.  CMS has required MSA for [...]

MMSEA Section 111 reporting is an element of the larger concept of Medicare Secondary Payer (MSP), which, simply put, establishes an obligation on entities and persons to protect Medicare’s interests in resolving claims in which medical specials are claimed or released. Efforts by defendants in personal injury claims to deflect this obligation via release language [...]

With the obligation to file MMSEA Section 111 reports on claims involving TPOC’s (Total Payment Obligation to the Claimant; i.e., settlements) now merely months away, we speculate as to the manner in which CMS will substantiate another delay in reporting if (when?) such a delay is announced, and what the implications might be as far [...]