LifeWallet Announces New Comprehensive Settlement with a Group of Affiliated Property & Casualty Insurers and Completion of First Version of LifeWallet’s Clearinghouse System Through its Exclusive Healthcare Partnership with Palantir Technologies
LifeWallet (NASDAQ: LIFW) has announced a new comprehensive settlement with a group of affiliated P&C insurers, following two previous settlements in the past five months. This agreement aims to resolve improperly paid claims affecting the Medicare Trust Fund. Key aspects include:
1. P&C Insurers will provide 10 years of historical data and future claims data.
2. Implementation of LifeWallet's coordination of benefits clearinghouse solution.
3. A 10-year agreement for cooperative resolution of Medicare claims.
4. Cash payment to settle existing historical claims.
Additionally, LifeWallet has completed the first version of its clearinghouse solution through its partnership with Palantir Technologies, enhancing its Chase to Pay model and data analytics capabilities.
LifeWallet (NASDAQ: LIFW) ha annunciato un nuovo accordo globale con un gruppo di assicuratori P&C affiliati, dopo due precedenti accordi negli ultimi cinque mesi. Questo accordo mira a risolvere le richieste di risarcimento pagate in modo non corretto che influenzano il Fondo di Previdenza Medicare. Gli aspetti chiave includono:
1. Gli assicuratori P&C forniranno 10 anni di dati storici e dati su future richieste di risarcimento.
2. Implementazione della soluzione di clearinghouse per il coordinamento dei benefici di LifeWallet.
3. Un accordo di 10 anni per la risoluzione cooperativa delle richieste di risarcimento Medicare.
4. Pagamento in contanti per risolvere le richieste storiche esistenti.
In aggiunta, LifeWallet ha completato la prima versione della sua soluzione di clearinghouse grazie alla partnership con Palantir Technologies, migliorando il suo modello Chase to Pay e le capacità di analisi dei dati.
LifeWallet (NASDAQ: LIFW) ha anunciado un nuevo acuerdo integral con un grupo de aseguradoras P&C afiliadas, tras dos acuerdos previos en los últimos cinco meses. Este acuerdo tiene como objetivo resolver las reclamaciones pagadas de manera inapropiada que afectan al Fondo Fiduciario de Medicare. Los aspectos clave incluyen:
1. Las aseguradoras P&C proporcionarán 10 años de datos históricos y datos sobre futuras reclamaciones.
2. Implementación de la solución de clearinghouse para la coordinación de beneficios de LifeWallet.
3. Un acuerdo de 10 años para la resolución cooperativa de las reclamaciones de Medicare.
4. Pago en efectivo para resolver las reclamaciones históricas existentes.
Además, LifeWallet ha completado la primera versión de su solución de clearinghouse a través de su asociación con Palantir Technologies, mejorando su modelo Chase to Pay y las capacidades de análisis de datos.
LifeWallet (NASDAQ: LIFW)는 지난 5개월 동안 두 번의 정산 이후, 관련 P&C 보험사 그룹과 새로운 포괄적 합의를 발표했습니다. 이 계약은 Medicare 신탁 기금에 영향을 미치는 잘못 지급된 청구를 해결하기 위한 것입니다. 주요 내용은 다음과 같습니다:
1. P&C 보험사는 10년간의 역사적 데이터와 미래 청구 데이터를 제공합니다.
2. LifeWallet의 수혜자 조정 클리어링하우스 솔루션이 구현됩니다.
3. Medicare 청구를 공동으로 해결하기 위한 10년 계약.
4. 기존 역사적 청구를 해결하기 위한 현금 지급.
추가로, LifeWallet은 Palantir Technologies와의 파트너십을 통해 클리어링하우스 솔루션의 첫 번째 버전을 완료하였으며, Chase to Pay 모델과 데이터 분석 능력을 향상시켰습니다.
LifeWallet (NASDAQ: LIFW) a annoncé un nouvel accord global avec un groupe d'assureurs P&C affiliés, suite à deux précédents accords au cours des cinq derniers mois. Cet accord vise à résoudre des demandes de remboursement mal payées affectant le Fonds de confiance Medicare. Les principaux aspects incluent :
1. Les assureurs P&C fourniront 10 ans de données historiques et de données sur les futures demandes.
2. Mise en œuvre de la solution de clearinghouse pour la coordination des avantages de LifeWallet.
3. Un accord de 10 ans pour la résolution coopérative des demandes Medicare.
4. Paiement en espèces pour régler les demandes historiques existantes.
De plus, LifeWallet a complété la première version de sa solution de clearinghouse grâce à son partenariat avec Palantir Technologies, améliorant ainsi son modèle Chase to Pay et ses capacités d'analyse de données.
LifeWallet (NASDAQ: LIFW) hat eine neue umfassende Einigung mit einer Gruppe von angeschlossenen P&C-Versicherern bekannt gegeben, nach zwei vorherigen Einigungen in den letzten fünf Monaten. Dieses Abkommen zielt darauf ab, falsch bezahlte Ansprüche zu lösen, die den Medicare Trust Fund betreffen. Zu den wichtigen Aspekten gehören:
1. Die P&C-Versicherer werden 10 Jahre historische Daten und zukünftige Anspruchsdaten bereitstellen.
2. Umsetzung der Clearinghouse-Lösung zur Koordinierung der Leistungen von LifeWallet.
3. Ein 10-jähriger Vertrag zur kooperativen Lösung von Medicare-Ansprüchen.
4. Barzahlung zur Regelung bestehender historischer Ansprüche.
Darüber hinaus hat LifeWallet die erste Version seiner Clearinghouse-Lösung über die Partnerschaft mit Palantir Technologies abgeschlossen und damit sein Chase to Pay-Modell und die Datenanalysefähigkeiten verbessert.
- New comprehensive settlement with P&C insurers, potentially increasing recoveries
- Access to 10 years of historical data and future claims data from P&C insurers
- Implementation of LifeWallet's clearinghouse solution by P&C insurers
- 10-year agreement for cooperative resolution of Medicare claims
- Cash payment received from P&C insurers to settle existing historical claims
- Completion of first version of clearinghouse solution with Palantir Technologies
- Enhanced data analytics capabilities through partnership with Palantir
- Specific settlement amount subject to confidentiality, limiting transparency
- No guarantee that other Primary Payers will settle on similar terms
- Potential challenges in reconciling and collecting on owned claims
Insights
The recent settlement is a significant development for LifeWallet. This settlement with a group of affiliated Property & Casualty (P&C) insurers will likely enhance LifeWallet's financial position through both monetary and non-monetary gains. The ten-year agreement for data sharing and binding mediation to resolve Medicare claims is particularly valuable. The access to historical and future claims data will enable LifeWallet to identify and recover on claims more efficiently, potentially boosting its revenue streams.
The cash payment from the P&C insurers, despite being confidential, likely represents a substantial immediate inflow of capital. This improves short-term liquidity, which is important for a company focusing on extensive legal and data-driven healthcare recovery efforts. Coupled with LifeWallet's ongoing negotiations with other insurers, this settlement underscores a strategic shift towards a more collaborative and streamlined approach to claim recovery, which could lead to more stable and predictable revenue growth in the long term.
Moreover, the announcement of the completion of the first version of the clearinghouse system in partnership with Palantir Technologies should not be overlooked. It showcases LifeWallet's investment in advanced data analytics capabilities, which could improve operational efficiencies and support further claim discoveries and recoveries.
The completion of the first version of LifeWallet’s clearinghouse system through its partnership with Palantir Technologies is a noteworthy advancement. Leveraging Palantir Foundry's platform for AI tools, natural language processing and machine learning, LifeWallet now has a sophisticated data analytics system to manage healthcare data. This system enhances their Chase to Pay model and can process and analyze vast amounts of data from various stakeholders including patients, attorneys, healthcare providers and P&C insurers.
The impact of this system is multifaceted. It will likely streamline the identification and resolution of claims, reducing manual intervention and hence operational costs. Furthermore, the real-time data-driven solutions can provide immediate insights, improving decision-making processes and reducing the time taken to recover payments. This technological advancement places LifeWallet at a competitive advantage, as it can handle complex data environments more efficiently, potentially leading to higher recovery rates and better client satisfaction.
The legal implications of the comprehensive settlement and the establishment of a clearinghouse are profound. The ten-year agreement to resolve Medicare claims through binding mediation or cooperative resolution indicates a significant reduction in legal hurdles and associated costs. This move towards mediation over litigation aligns with cost-saving strategies and speeds up the claims recovery process.
Moreover, the agreement for the P&C insurers to share historical and future claims data and for them to acknowledge their role as primary payers, adds a layer of legal clarity and responsibility. This could lead to fewer disputes and more straightforward claim recoveries. The legal infrastructure supporting this settlement reflects a robust strategy to enforce payer obligations, potentially setting a precedent for future agreements within the industry.
CORAL GABLES, Fla., July 22, 2024 (GLOBE NEWSWIRE) -- MSP Recovery, Inc. d/b/a LifeWallet (NASDAQ: LIFW) (“LifeWallet” or “the Company”) announces a new comprehensive settlement with another group of affiliated P&C insurers doing business in multiple states. This most recent settlement is in addition to two previously announced settlements within the past five months with multiple property and casualty insurers (“P&C insurers”) that have paved the way for the discovery and potential recovery of improperly paid claims on the part of Medicare Payers, that should have been paid by primary payers.1 These improper payments affect the Medicare Trust Fund. As described by a federal appellate judge, when Secondary Payers “recover efficiently from Primary Payers, the Medicare Trust Fund does achieve cost savings.”2
This latest settlement offers a going-forward process to collaboratively and timely resolve future claims and share important historical data that is expected to enhance LifeWallet’s claims reconciliation capabilities, identifying claims owned by LifeWallet that it may have a right to recover on, benefiting Medicare plans and downstream entities across the mainland U.S. and Puerto Rico.
Details of the settlement include:
- The P&C Insurers’ agreement to provide ten years of historical data (identifying all claims processed from January 1, 2014, through the effective date) and data sharing of future claims, extending out for one year, assisting LifeWallet in reconciling its current and future assigned Medicare claims to be able to collect on owned claims that are owed as a result of failure to pay or reimburse;
- The P&C Insurers’ Implementation of LifeWallet’s coordination of benefits clearinghouse solution;
- A 10-year agreement to resolve cooperatively, or through binding mediation, relevant Medicare claims (liens) that LifeWallet owns today and in the future;
- The P&C Insurers’ agreement that they are primary payers for any unreimbursed Medicare lien that LifeWallet identifies from data sharing, and the P&C Insurers’ agreement to assign all rights to collect against other third parties that either failed to pay liens or collected twice from Medicare funds and the P&C Insurers; and
- A cash payment from the P&C Insurers to LifeWallet to settle existing historical claims (amount subject to confidentiality).
LifeWallet is also currently in negotiations with multiple other property and casualty insurers to resolve claims on a similar basis. The settlement announced today follows two previous comprehensive settlements announced by LifeWallet on April 18, 2024 and Mar 3, 2024 with 28 affiliated P&C Insurers. These settlement agreements are the result of LifeWallet’s more than ten-year commitment to revolutionize the fragmented healthcare reimbursement system with data-driven solutions, utilizing its extensive legal infrastructure to enforce Primary Payer1 obligations (from mostly property and casualty insurers), through years of federal and state litigation. LifeWallet notes these settlements are not a guarantee that LifeWallet’s portfolio of assigned claims (owed by other Primary Payers) can be settled with the same or similar terms. The settlement value is a combination of monetary and non-monetary considerations, with the non-monetary considerations involving LifeWallet obtaining data on all the claims that were processed and paid by the P&C Insurers, and the P&C Insurers’ assignment of rights to collect against other responsible parties. This will enhance LifeWallet’s ability to discover liens and recover payments owed, more quickly than through litigation. It also enables LifeWallet to pursue a diversified number of entities that failed to pay liens or collected twice for the same bills, both from the insurer and LifeWallet’s assignor clients.
LifeWallet’s Clearinghouse Solution
In addition, LifeWallet announces the completion of the first version of the Company’s clearinghouse solution through its exclusive healthcare partnership with Palantir Technologies (NYSE: PLTR). This enhances LifeWallet’s Chase to Pay model, through an ongoing partnership with Palantir, utilizing the Palantir Foundry platform; AI tools, natural language processing, and machine learning; resulting in the development of a sophisticated data analytics system that captures and manages healthcare data. The LifeWallet/Palantir clearinghouse builds upon previously announced initiatives: “MSP Recovery and Palantir to Transform Connectivity Across the U.S. Healthcare System” , providing real-time data driven solutions that focus on data from patients, attorneys, healthcare providers, and healthcare insurers, as well as property and casualty insurers, all designed to build an expansive repository of data that can be used to determine medical conditions as well as payer obligations. The system was instrumental in the recent class certification in June 2024 against USAA Property and Casualty Company, exemplifying the breadth and depth of the systemic issues plaguing the healthcare system.
LifeWallet’s Chief Information Officer, Christopher Miranda, commented on today’s announcements saying, “Our comprehensive strategy incorporating healthcare industry knowledge, advanced data technology, and legal know-how is helping accelerate potential recoveries, while creating data-driven solutions to decades-old problems, resulting in improved outcomes for healthcare payers, providers and patients.”
Forward Looking Statements
This press release contains forward-looking statements within the meaning of the federal securities laws. Forward-looking statements may generally be identified by the use of words such as “anticipate,” “believe,” “expect,” “intend,” “plan" and “will” or, in each case, their negative, or other variations or comparable terminology. These forward-looking statements include all matters that are not historical facts, including for example statements regarding potential future settlements. By their nature, forward-looking statements involve risks and uncertainties because they relate to events and depend on circumstances that may or may not occur in the future. As a result, these statements are not guarantees of future performance or results and actual events may differ materially from those expressed in or suggested by the forward-looking statements. Any forward-looking statement made by the Company herein speaks only as of the date made. New risks and uncertainties come up from time to time, and it is impossible for the Company to predict or identify all such events or how they may affect it. the Company has no obligation, and does not intend, to update any forward-looking statements after the date hereof, except as required by federal securities laws. Factors that could cause these differences include, but are not limited to, the Company’s ability to capitalize on its assignment agreements and recover monies that were paid by the assignors; the inherent uncertainty surrounding settlement negotiations and/or litigation, including with respect to both the amount and timing of any such results; the success of the Company's scheduled settlement mediations; the validity of the assignments of claims to the Company; negative publicity concerning healthcare data analytics and payment accuracy; and those other factors included in the Company’s Annual Report on Form 10-K, Quarterly Reports on Form 10-Q and other reports filed by it with the SEC. These statements constitute the Company’s cautionary statements under the Private Securities Litigation Reform Act of 1995.
About LifeWallet
Founded in 2014 as MSP Recovery, LifeWallet has become a Medicare, Medicaid, commercial, and secondary payer reimbursement recovery leader, disrupting the antiquated healthcare reimbursement system with data-driven solutions to secure recoveries from responsible parties. LifeWallet provides comprehensive solutions for multiple industries including healthcare, legal, education, and sports NIL. For more information, visit: LIFEWALLET.COM.
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1 “Primary Plans” or “Primary Payers,” when used in the Medicare Secondary Payer context, means “any entity that is or was required or responsible to make payment with respect to an item or service (or any portion thereof) under a primary plan. These entities include, but are not limited to, insurers or self-insurers, third party administrators, and all employers that sponsor or contribute to group health plans or large group health plans.” 42 C.F.R. § 411.21.
2 3 In re Avandia Mktg., Sales Pracs. & Prod. Liab. Litig., 685 F.3d 353, 365 (3d Cir. 2012)
CONTACTS
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