LifeWallet Announces New Comprehensive Settlements Totaling More Than $5.9 Million, Continued Progress in Recoveries on Owned Claims and Acquiring Rights to Additional Claims, and Initiatives to Eliminate Wasteful Medicare Spending by Launching Beta Testin
12 November 2024 - 4:21AM
MSP Recovery, Inc. d/b/a LifeWallet (NASDAQ: LIFW)
(“LifeWallet” or “the Company”) announces new
comprehensive settlements totaling more than $5.9 million,
continued progress in recoveries on owned claims and acquiring
rights to additional claims, and advancing initiatives to eliminate
wasteful spending of Medicare dollars and improve federal
cost-cutting measures by reducing improper payments made by
healthcare entities across the United States.
Medical Device Settlement:
LifeWallet entered into a confidential settlement agreement with
a product manufacturer totaling $760,000. As part of LifeWallet’s
owned claims portfolio, the Company has ongoing litigation against
other pharmaceutical and medical device manufacturers based on
claims of defective products or anti-competitive pricing. These
settlements are not a guarantee that LifeWallet’s portfolio of
assigned claims can be settled with the same or similar terms.
Property & Casualty Settlements:
LifeWallet entered into two comprehensive settlements with
property and casualty insurers (P&C Insurers), totaling more
than $5.2 million, which offer a going-forward process to
collaboratively and timely resolve future claims and share
important historical data. This is expected to enhance LifeWallet’s
claims reconciliation capabilities by 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.
Some of these settlements require the P&C Insurers to
provide data by way of an Application Programming Interface to the
LifeWallet clearinghouse platform that was designed and created by
LifeWallet and Palantir Technologies, Inc. (NYSE: PLTR). The
clearinghouse is a hybrid between a statistical analysis system
model and one that identifies improper payments, while also having
the capability to provide patients, providers and attorneys with an
individual’s current and past medical conditions as they relate to
improper payments or potential claims against the world’s largest
pharmaceutical and medical device companies.
Details of the two settlements 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;
- 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;
- A cash payment from the P&C Insurers to LifeWallet to
settle existing historical claims; and
- The opportunity for the P&C Insurers to implement
LifeWallet’s coordination of benefits clearinghouse solution.
LifeWallet is also currently in negotiations with other property
and casualty insurers to resolve claims on a similar basis,
including one of the country’s largest P&C Insurers. Some of
these negotiations have resulted in collaborative statistical
sampling and extensive data matching to determine the size and
scope of claims that are owned by the Company that LifeWallet has
asserted repayment is due pursuant to Medicare Secondary Payer and
other related laws. These insurers are acting in good faith to
attempt to resolve these disputes. As with other achieved
settlements, LifeWallet attempts to reach agreements to resolve
historical claims without litigation for ten (10) years moving
forward.
The two settlements announced today follow three previous
comprehensive settlements announced by LifeWallet on April 18,
2024, March 3, 2024 and July 22, 2024, totaling nearly 70
(affiliated and non-affiliated) property and
casualty insurers. These settlement agreements are the result
of LifeWallet’s decade-long commitment to revolutionize the
fragmented healthcare reimbursement system with data-driven
solutions, utilizing its extensive legal infrastructure to enforce
Primary Payer 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 values are 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. LifeWallet
expects that this will enhance its ability to discover liens and
recover payments owed more efficiently 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.
Federal Cost-Cutting and Eliminating Wasteful Spending
Through LifeWallet/Palantir Clearinghouse
In 2023, the Centers for Medicare & Medicaid Services (CMS)
estimated that Medicare lost $31.2 billion due to improper
payments, which was 7.38% of the Medicare Fee-for-Service (FFS)
program. LifeWallet is advancing initiatives to eliminate this
wasteful spending and unnecessary Medicare secondary payments,
utilizing its clearinghouse system, created through its exclusive
healthcare partnership with Palantir Technologies, Inc. The
clearinghouse solution utilizes 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, enhancing LifeWallet’s Chase
to Pay model.
After successful beta testing, the LifeWallet/Palantir
clearinghouse continues to build 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 create an expansive repository
of data that can be used to determine medical conditions as well as
payer obligations.
LifeWallet’s CEO John H. Ruiz is of the opinion these
technological advancements will ignite a new era of collaboration,
efficiency, and cost-savings, saying, “Systemic issues have plagued
the healthcare system for decades. We have built solutions for the
public and private sector to cut unnecessary healthcare costs and
save billions of taxpayer dollars, benefitting every American, and
that is something we can all unite behind.”
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, and sports
NIL. For more information, visit: LIFEWALLET.COM.
CONTACTS
Mediamedia@lifewallet.com
InvestorsInvestors@LifeWallet.com
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