The 2023 Florida Statutes (including Special Session C)
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. . . the private cause of action for the Medicare Act, and another for breach of contract under 42 C.F.R. 411.24 . . .
. . . . §§ 411.24(g), 422.108(f). . . .
. . . . § 411.24(f)(1) (DE 117, at 2, 8). . . . Finally, the regulation Plaintiff cites, 42 C.F.R. § 411.24(f)(1) (DE 117, at 8) is in no way inconsistent . . . with the plain language of § 1395y(b)(2)(B)(vi). 42 C.F.R. § 411.24(f)(1) ("CMS may recover without . . .
. . . . § 411.24(f) is Invalid. . . . . § 411.24(f) in support of its broad preemption argument. 42 C.F.R. § 411.24(f) provides that Medicare . . . More importantly, however, § 411.24(f) was declared invalid in Health Ins. . . . In Shalala, an insurance association claimed § 411.24(f) exceeded the statutory authority delegated to . . . After reviewing the controlling statutes, the court agreed 411.24(f) was void. . . .
. . . . § 411.24(h) (providing that a beneficiary who receives a primary payment "must reimburse Medicare within . . .
. . . . § 411.24, which is entitled "Recovery of Conditional Payments" and states under Section (c) "Amount . . . Second, Plaintiff claims that 42 C.F.R. § 411.24(h) requires that reimbursement be tendered within 60 . . . While it is true that 42 C.F.R. § 411.24(h) states that "[i]f the beneficiary or other party receives . . . See 42 C.F.R. § 411.24(m). . . . (DE 26 at 4, citing 42 C.F.R. § 411.24(g) and 422.108(f) ). Again, they cite to Humana Med. . . .
. . . 42 of the Code of Federal Regulations (" section 411.24(g)"), which states that "CMS has a right of . . . See 42 C.F.R. § 411.24. . . . (citing section 411.24(i) )). . . . (citing section 411.24(i) )). . . . See id. § 411.24(i)(1). . . .
. . . . § 411.24 (describing a Government cause of action against a primary plan or any other person that received . . . and one against any entity (including a beneficiary) that receives a primary payment. 42 C.F.R. §§ 411.24 . . . (e), 411.24(g). . . . reimburse Medicare even though it has already reimbursed the beneficiary or other party*” 42 C.F.R. § 411.24 . . . See id. § 411.24(i)(l). . . .
. . . . § 411.24(b). . . . See 42 C.F.R. § 411.24(g) (“CMS has a right of action to recover its payments from any entity, including . . . . compensation, any liability or no-fault insurance, or an employer group health plan,” 42 C.F.R. § 411.24 . . . See 42 C.F.R. § 411.24(g) (“CMS has a right of action to recover its payments from any entity, including . . .
. . . . § 411.24(g). . . .
. . . . § 411.24(h). . . . reimburse Medicare even though it has already reimbursed the beneficiary or other party.” 42 C.F.R. §§ 411.24 . . .
. . . . § 411.24(g) (2014); U.S. v. Harris, No. 5:08CV102, 2009 WL 891931, at *3, *5 (N.D.W.Va. . . .
. . . . § 411.24(h). . . . reimburse Medicare even though it has already reimbursed the beneficiary or other party.” 42 C.F.R. § 411.24 . . .
. . . . § 411.24(f)(1) ("CMS may recover without regard to any claims filing requirements that the insurance . . . program or plan imposes on the beneficiaiy or other claimant”); 42 C.F.R. § 411.24(c) (providing amount . . .
. . . . § 411.24(e), (g). . . .
. . . . § 411.24(g) (Medicare “has a right of action to recover its payments from any entity, including a beneficiary . . . represents direct application of the Secretary’s interpretation of her authority under 42 C.F.R. § 411.24 . . . Because 42 C.F.R. § 411.24(g) provides that Medicare “has a right of action to recover its payments from . . . And 42 C.F.R. § 411.24(h) states that “[i]f the beneficiary or other party receives a primary payment . . . Whether we analyze 42 C.F.R. § 411.24(g) individually, or in conjunction with 42 C.F.R. § 411.24(h) is . . .
. . . . § 411.24(g) (Medicare “has a right of action to recover its payments from any entity, including a beneficiary . . . represents direct application of the Secretary’s interpretation of her authority under 42 C.F.R. § 411.24 . . . Because 42 C.F.R. § 411.24(g) provides that'Medieare “has a right of action to recover its payments from . . . And 42 C.F.R. § 411.24(h) states that “[i]f the beneficiary or other party receives a primary payment . . . Whether we analyze 42 C.F.R. § 411.24(g) individually, or in conjunction with 42 C.F.R. § 411.24(h) is . . .
. . . . § 411.24(g). . . . See also 42 C.F.R. § 411.24(i)(l) (“If Medicare is not reimbursed as required ... the primary payer must . . . In relevant part, 42 C.F.R. § 411.24(e) gives the government “a direct right of action to recover from . . . The import of these regulatory provisions, § 411.22(b) and § 411.24(b) — which have not been challenged . . . See 42 C.F.R. § 411.24(i)(2). . . . .
. . . . § 411.24(¿). . . .
. . . State agency or private insurer that has received a primary payment” may also be held liable. 42 CFR § 411.24 . . .
. . . . §§ 411.24(c), 411.37(c). As observed by the majority, in Zinman v. . . .
. . . . § 411.24(h). . . . . § 411.24(i)(l) (stating “If Medicare is not reimbursed ..., the primary payer must reimburse Medicare . . . See 42 U.S.C. § 1395y(b)(2) and 42 C.F.R. § 411.24(0(1). . . .
. . . . § 411.24(h)). . . . reimburse Medicare even though it has already reimbursed the beneficiary or other party.” 42 C.F.R. § 411.24 . . . defined an entity as “a supplier, beneficiary, attorney, State agency, or private insurer.” 42 C.F.R. § 411.24 . . . entity” to include: “a supplier, beneficiary, attorney, State agency, or private insurer.” 42 C.F.R. § 411.24 . . . See 42 C.F.R. § 411.24(h) and (i)(l). . . .
. . . . § 411.24. . . . Id. § 411.24(h). . . . . § 411.24(m)(2)(i)-(ii). . . .
. . . components” and “provide[s] the desired shape and structure of the seat,” '317 patent col.2 11.23-25; col.411.24 . . .
. . . . § 411.24, although CMS may waive its rights in the best interests of Medicare, see 42 U.S.C. § 1395y . . .
. . . . § 411.24(g) (government has right of action against beneficiary that has received primary payment); . . .
. . . . § ]411.24(i), a ‘third party payer’ may be required to reimburse Medicare if it paid a provider or . . .
. . . . § 411.24(h) (2004) (“If the beneficiary or other party receives a third party payment, the beneficiary . . .
. . . For example, 42 C.F.R. 411.24 establishes procedure for recovery of erroneous payments. 42 C.F.R. 411.25 . . . the courts offer a wide variety of options through which Medicare can pursue reimbursement. 42 C.F.R. 411.24 . . .
. . . . § 411.24(i)(2). . . . . § 411.24(h), then “the third party payer must reimburse Medicare even though it has already reimbursed . . . the beneficiary or other party.” 42 C.F.R. § 411.24(0(1). . . .
. . . . §§ 411.21 (defining “conditional payment”), 411.24 (recovery of conditional payments), 411.52 (conditional . . .
. . . Interest will be calculated at the rate of 13.75% per annum in accordance with 42 C.F.R. 411.24(m). . . .
. . . . § 411.24. . . . Under § 411.24®, a “third party payer” may be required to reimburse Medicare if it paid a provider or . . . The pertinent regulations to which we owe deference are codified at 42 C.F.R. §§ 411.24(c)(1) and (c) . . . The Government cited the regulations in its Complaint, but did not rely on § 411.24(c) in its briefs . . . The agency’s implementing regulation, 42 C.F.R. § 411.24(g), lists as examples of entities liable as . . .
. . . . § 411.24(e) & (g). . . . It argues that under § 411.24(i)(l) it may collect a second payment from liability insurance companies . . . In explaining § 411.24(c), HCFA said “any claimant may seek double damages from any entity responsible . . . The entities listed in § 411.24(g) are typical “final recipients” of third party payments. . . . (h), 411.24©. . . .
. . . Interest will be calculated at the rate of 13.75% per annum in accordance with 42 C.F.R. 411.24(m). . . .
. . . . § 411.24(g) Medicare is also entitled to a setoff of third-party payments made to a state Medicaid . . . See id. at § 411.24(j). . . . See id. at § 1395y(b)(2)(B)(i); 42 C.F.R. §§ 411.24, 411.52 (2001). . . .
. . . . §§ 411.21, 411.24(e), (g). . . .
. . . . § 411.24(i)(2)). . . . As for the MSPA, the United States cited 42 C.F.R. § 411.24. . . . . § 411.24(i)(l). . . . that payment for such item or service has been or could be made under [paragraph 2(A)].”); 42 C.F.R. § 411.24 . . . party payment, the beneficiary or other party must reimburse Medicare within 60 days.” 42 C.F.R. § 411.24 . . .
. . . . § 411.24(e). . . .
. . . . § 411.24(g); 411.26. . . . Id. at 843; see 42 C.F.R. §§ 411.24(c), .37(c). . . . conditional payments when the beneficiary’s settlement is less than the total damages. 42 C.F.R. § 411.24 . . .
. . . . § 411.24(c). . . .
. . . . § 411.24(e). . . . HCFA’s “third party administrator” regulation, 42 C.F.R. § 411.24(e), also effects a substantive change . . . By holding third party administrators liable for repayment of conditional Medicare payments, § 411.24 . . . Consequently, the government could not validly apply 42 C.F.R. § 411.24(e) to claims and payments made . . . As to the court’s holding that HCFA’s “third party administrator” regulation, 42 C.F.R. § 411.24(e), . . . . § 411.24(i)), the mandatory notice regulation (42 C.F.R. § 411.25(a)) and the carve out coverage regulation . . . the claims filing regulation (42 C.F.R. § 411.-24©) and third-party liability regulation (42 C.F.R. § 411.24 . . . “an employer, an insurance carrier, plan, or program, and a third party administrator.” 42 C.F.R. § 411.24 . . . The appellants also challenge 42 CFR § 411.24(i), which they have dubbed “the double-payment regulation . . . C. 4.2 CFR § 411.24(f) — override of claims procedures. . . . The final regulation challenged by both appellants is 42 CFR § 411.24(f), which asserts that Medicare . . . Conclusion To sum up, we agree with the appellants that 42 CFR §§ 411.24© and 411.24(e) go beyond the . . . But we reject the appellants’ facial challenges to §§ 411.-32(a)(1), 411.25, and 411.24(i). . . .
. . . . § 411.24(g) HCFA has a right to seek recovery of third party payments from attorneys. . . .
. . . . § 411.24(g) and § 411.26 clarify the United States’ sub-rogation right and its right to file suit against . . .
. . . . § 411.24, entitled “Recovery of conditional payments,” provides in part: (g) Recovery from parties . . . entity, including a beneficiary or an attorney, which has received a third party payment. 42 C.F.R. § 411.24 . . . See 42 C.F.R. § 411.24(h). . . . See 42 C.F.R. § 411.24(g). . . .
. . . . § 411.24; 54 Fed.Reg. No. 195 at 41738-40 (Oct. 11, 1989). . . .
. . . . § 411.24(i) is arbitrary and capricious. I. . . . (e) Both plaintiffs challenge 42 C.F.R. § 411.24(e) which states: Recovery from third parties. . . . Under step two, the court cannot find that section 411.24(e) is an unreasonable interpretation of the . . . (f) Plaintiffs also challenge 42 C.F.R. § 411.24(f), which provides: Claims filing requirements. (1) . . . ® Plaintiffs also assert that 42 C.F.R. § 411.24(i) violates the APA. . . .
. . . . § 411.24; 54 Fed.Reg. No. 195 at 41738 (Oct. 11, 1989). . . . party payment, the beneficiary or other party must reimburse Medicare within 60 days.” 42 C.F.R. § 411.24 . . . HCFA has a right of recovery against any entity which has received a third party payment. 42 C.F.R. § 411.24 . . .
. . . a result of his death, decedent’s surviving spouse, Reta, was entitled to and received payments of $411.24 . . .
. . . having payments due under the contract withheld, at an additional expense plus a reasonable profit of $411.24 . . .
. . . in that it found for the plaintiff in the sum claimed together with interest in the further sum of $411.24 . . .