Fourth Circuit Sides with Medicare Advantage Plan

In Humana v. Paris Blank, LLP et al 2016 U.S. Dist. LEXIS 61814, Paris Blank, LLP, a plaintiff law firm, was sued by Humana Medicare Advantage for failing to reimburse Humana for conditional payments.  This is the first time an MSP Private Cause of Action has been...

E.M.A. ex rel. Plyler v. Cansler

The Supreme Court granted Cert  in E.M.A. ex rel. Plyler v. Cansler, 674 F.3d 290 (4th Cir.2012).  In this case, the 4th Circuit upheld the application of Ahlborn’s pro rata loss sharing formula for a Medicaid reimbursement claim.  The North Carolina Attorney General...
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