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Thursday, May 16, 2013

State Law Does Not Preempt State Medical Authorization Criteria

The 5th Circuit Court of Appeals has ruled that The Texas Workers' Compensation Act does not preempt the Medicare Secondary Payer (MSP) 42 U.S.C.§ 1395y(b), as to the state statute's mandated requirement to obtain preauthorization for medical care. 

The Court ruled that.  "...Congress explicitly prohibited workers' compensation and other insurers from subordinating their payment obligations to those of Medicare." "....Congress intended the MSP to complement, not supplant, state workers' compensation rules."

Caldera v. Insurance Co, of the State of PA, ____ F.3rd ___, 2013 WL 1975660 C.A.5 (Tex), 2013. Decided May 14, 2013.

Read more about "MSP" and workers' compensation:
Jan 19, 2013
The court declared the MSP action alleged in the complaint moot as it granted the motion to dismiss on the injunctive relief issue. The plaintiff/beneficiary sought to allege a private cause of action for double damages against ...
Jan 11, 2013
Obama signs MSP Medicare bill. "The legislation changes the way Medicare collects money from people whose negligence caused a patient to incur medical bills. Murphy said the new law will streamline an outdated process, ...
Oct 01, 2012
US Supreme Court Denies CMS-MSP Case - Hadden. 2012 WL 1106757. Supreme Court of the United States. HADDEN, VERNON V. UNITED STATES. No. 11-1197.Oct. 1, 2012. Opinion. The petition for writ of certiorari is ...
May 18, 2011
"IT IS FURTHER ORDERED that the Defendant's demand that attorneys withhold liability proceeds from clients pending payment of amounts claimed by the Defendant as MSP reimbursement exceeds her authority under the ...