tci Medicare Compliance & Reimbursement - 2003 Issue 7

Enforcement: MSP BLUES

The Department of Justice Feb. 11 partially intervened in a whistleblower suit accusing Pittsburgh, PA-based insurer Highmark Inc. of playing fast and loose with Medicare Secondary Payer rules — and demoting the woman charged with ensuring that the company complied with MSP requirements. The case was originally filed in 2000 by Elizabeth Drescher, a Highmark employee charged, according to the lawsuit, with overseeing the company’s compliance with MSP rules in the wake of a 1995 agreement between the feds and a number of Blue Cross and Blue Shield plans, including Highmark’s predecessor company. The lawsuit maintains that...

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