Mark Popolizio

Mark Popolizio

Mark Popolizio is the Vice President of MSP Compliance and Policy for ISO Claims Partners. Mark’s area of specialty is Medicare secondary payer compliance. He authors regular articles and provides educational presentations across the country on MSP issues. Mark's e-mail address is mpopolizio@iso.com.

CMS to host Town Hall Meeting to discuss CRC ORM recovery issues related to NGHP claims

The Centers for Medicare and Medicaid Services (CMS) has announced that it will host a telephonic Town Hall meeting to discuss recovery issues related to the Commercial Repayment Center (CRC) and on-going responsibili...

Illinois court dismisses Medicare Advantage Plan suit for “double damages” on standing grounds

In MAO-MSO Recovery II, LLC v. State Farm , 2019 WL 6311987 (C.D. Ill. Nov. 25, 2019), [1] the United States District Court for the Central District of Illinois found that an assignee of a Medicare Advantage Plan (MAP...

CMS retains its $750 “Low Dollar” threshold for 2020

The Centers for Medicare and Medicaid Services (CMS) has released its low dollar recovery threshold for 2020 via a new alert . CMS is generally required to publish an annual low dollar threshold amount according to...

CMS’s expected release of its “future medicals” (LMSA) proposals delayed until February 2020

The Office of Information and Regulatory Affairs (OIRA) has issued an updated notice   indicating that the Centers for Medicare and Medicaid Services (CMS) expected release of its Notice of Proposed Rulemaking (NPRM)...

Release of CMS’s Section 111 penalty proposals delayed again – pushed back to December

The Office of Information and Regulatory Affairs (OIRA) has issued an updated notice indicating that the Centers for Medicare and Medicaid Services’ (CMS) expected release of its Notice of Proposed Rulemaking (NPRM)...

CMS’s new Section 111 Alert addresses MBI reporting

The Centers for Medicare and Medicaid Services (CMS) has issued an updated Section 111 Alert pertaining to non-group health claims (NGHP) regarding the Medicare Beneficiary Identifier (MBI) reporting.    Through CMS’s...

Liability Medicare Set Asides – Bracing for the Storm

For years, the Liability Medicare Set-Aside (LMSA) issue has been the source of much debate and frustration for liability claims payers. To date, there remain lingering questions on several fronts and the Centers for...

CMS releases new WCMSA Reference Guide (Version 3.0)

The Centers for Medicare and Medicaid Services (CMS) has released a revised Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.0, October 10, 2019) . This guide replaces Version 2.9 of the gui...

Ninth Circuit: CIGA is not a “primary payer” under the MSP and does not have to reimburse Medicare

In a significant new case out of California, the United States Circuit Court of Appeals (Ninth Circuit) [1] in California Insurance Guarantee Association (CIGA) v. Azar , 2019 WL 5076945 (9 th Cir. Oct. 10, 2019)...

South Carolina court: Medicare Advantage Plan can sue for “double damages” under the Medicare Secondary Payer statute

The South Carolina District Court is the latest jurisdiction presented with the question of whether a Medicare Advantage Plan (MAP) can sue for “double damages” under the Medicare Secondary Payer’s (MSP’s) private cau...