Breaking: CMS Recovery Practice Ruled Improper under the MSP

In an important new case—CIGA v. Burwell, 2017 WL 58821 (C.D. California, January 5, 2017)—the court ruled that the CMS practice of seeking full reimbursement of a medical provider’s single charge—even where some unsegregated portion of that charge relates to services not covered by a workers compensation plan—was improper under the Medicare Secondary Payer Statute […]

CMS Releases Updated Reporting and Recovery Thresholds with News on TPOCs

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The Centers for Medicare and Medicaid Services (CMS) has released its latest alert regarding its low-dollar reporting and recovery thresholds pertaining to liability (including self-insurance), workers compensation, and no-fault settlements, judgments, awards, or other payments (settlements). CMS’s December 12, 2016, alert, Change in Reporting Thresholds for Certain Liability Insurance, No-Fault Insurance, and Workers’ Compensation Settlements, […]

Removing Roadblocks to Settlements: Medicare Part C Claims in the Way of Your Settlement

Marty Cassavoy

The last half-dozen years have seen Medicare Secondary Payer (MSP) compliance evolve, with the most recent example being its change in focus from mandatory insurer reporting to rolling recovery. But one of the most impactful changes involves Medicare Advantage Organizations (MAOs). Ten years ago, most practitioners didn’t even worry about them, but now insurers in […]

CMS to Hold Town Hall Call on November 17

Mark Popolizio

The Centers for Medicare and Medicaid Services (CMS) will conduct a Town Hall Teleconference November 17, 2016 (1:00 p.m. – 2:30 p.m. EST) to address numerous liability insurance (including self-insurance), workers compensation, and no-fault claims issues.  Click here to view CMS’s full notice and call-in instructions. CMS noted that it expects to discuss: Ongoing Responsibility […]

Zero Allocations: CMS backs down from drastic changes

Marty Cassavoy

As we outlined in a blog post last week, there’s been a lot of buzz surrounding the Centers for Medicare & Medicaid Services’ (CMS) approval of zero allocations. From the moment CMS proposed changes to the process, we outlined why we strongly believe that the workers compensation industry should not stand idly by while wholesale […]

CMS News Alert: Zero allocations are far from over

Martin-Cassavoy

The Centers for Medicare and Medicaid Services (CMS) made news this week by purportedly “correcting” their position on zero allocations. At ISO Claims Partners, we strongly believe that the industry should fight CMS on this and not blindly accept what amounts to an illogical application of CMS’s own stated policies. Background CMS’s purported position basically […]