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CMS Provides Additional Guidance Regarding The Delay Of The Reporting Requirement Under The Medicare Secondary Payer Statute

Client Alert | 1 min read | 03.02.10

As reported in our February 19, 2010 Client Alert, the Centers for Medicare and Medicaid Services ("CMS") announced that it will delay, from April 1, 2010 to January 1, 2011, the start date for electronic filing of settlements, judgments, awards, or other payments made to Medicare beneficiaries, whether such payments are made by liability insurers, no-fault insurers, workers' compensation, or businesses that self insure their liability risks. At the time of the announcement, CMS indicated that further guidance would be issued the week of February 22, 2010. Late last week, CMS issued the additional guidance in the form of new CMS Alerts and an updated User Guide for reporting entities.

One of the important questions regarding CMS's announcement was whether the reporting delay would result in a corresponding delay in the date of the settlements that will have to be reported to CMS. The new guidance issued by CMS indicates that there will, in fact, be a corresponding 9-month delay, and that only settlements entered into on or after October 1, 2010, will need to be reported to CMS, provided the settlement does not include an ongoing obligation for medical payments (such as is often seen with workers' compensation settlements). See User Guide, at 6 & 56. CMS noted in its guidance that reporting entities, however, will be permitted to report settlements entered into prior to October 1, 2010, should they wish to do so. Id.

Of particular importance to many companies involved in mass and toxic tort litigation, CMS staff announced that additional guidance will be issued soon relating to the reporting of settlement payments in such cases, particularly where the exposure at issue pre-dates December 5, 1980, the effective date of the relevant provision of the Medicare Secondary Payer Statute.

If you have any questions regarding any of these developments, or would like more information regarding the Medicare reporting program, please contact Bob Roth of our Health Care Group or Robert Willmore of our Torts Group.

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Client Alert | 5 min read | 12.12.25

Eleventh Circuit Hears Argument on False Claims Act Qui Tam Constitutionality

On the morning of December 12, 2025, the Eleventh Circuit heard argument in United States ex rel. Zafirov v. Florida Medical Associates, LLC, et al., No. 24-13581 (11th Cir. 2025). This case concerns the constitutionality of the False Claims Act (FCA) qui tam provisions and a groundbreaking September 2024 opinion in which the United States District Court for the Middle District of Florida held that the FCA’s qui tam provisions were unconstitutional under Article II. See United States ex rel. Zafirov v. Fla. Med. Assocs., LLC, 751 F. Supp. 3d 1293 (M.D. Fla. 2024). That decision, penned by District Judge Kathryn Kimball Mizelle, was the first success story for a legal theory that has been gaining steam ever since Justices Thomas, Barrett, and Kavanaugh indicated they would be willing to consider arguments about the constitutionality of the qui tam provisions in U.S. ex rel. Polansky v. Exec. Health Res., 599 U.S. 419 (2023). In her opinion, Judge Mizelle held (1) qui tam relators are officers of the U.S. who must be appointed under the Appointments Clause; and (2) historical practice treating qui tam and similar relators as less than “officers” for constitutional purposes was not enough to save the qui tam provisions from the fundamental Article II infirmity the court identified. That ruling was appealed and, after full briefing, including by the government and a bevy of amici, the litigants stepped up to the plate this morning for oral argument....

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