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 Releases New NGHP Section 111 User Guide

The Centers for Medicare and Medicaid Services (CMS) has updated its Non-Group Health Plan (NGHP) Section 111 User Guide . The new guide is styled as Version 5.5 and is dated January 7, 2019. Per...

CMS Preparing to Address Section 111 Reporting Penalties

The Office of Management and Budget (OMB) has issued a notice entitled Civil Money Penalties and Medicare Secondary Payer Reporting Requirements (CMS-6061-P) indicating that the Centers for Medicar...

CMS Retains $750 “Low Dollar” Threshold for 2019

The Centers for Medicare and Medicaid Services (CMS) has released its low dollar recovery threshold for 2019 via an alert dated November 15, 2018. CMS is generally required to publish an annual low...

CMS Updates its Medicare Prescription Drug Benefit Manual – New Changes Encourage Part D Collection and Recovery

The Centers for Medicare and Medicaid Services (CMS) has amended its Medicare Prescription Drug Benefit Manual (Part D Manual) to add, in part, stronger language regarding Medicare Part D sponsors’...

Law Firm Reaches Settlement with U.S. Department of Justice to Reimburse Medicare Conditional Payments and Start Internal MSP Compliance Program

The United States Department of Justice (DOJ) for the Eastern District of Pennsylvania has issued a news release reporting that a Philadelphia personal injury law firm has agreed to pay the...

Court Denies “Double Damages” under the MSP’s Private Cause of Action

Currently, there are two questions being litigated that involve who can sue under the Medicare Secondary Payer’s (MSP) private cause of action (PCA) provision and when “double damages” may apply. I...

Arizona Tweaks its "Full & Final" Workers' Comp Settlement Law - New Law Provides Opportunities to Settle Workers' Comp Claims

On October 31, 2017, Arizona Senate Bill (S.B.) 1332 became law allowing Arizona claims payers to reach “full and final” settlements of certain workers’ compensation (WC) claims. This new law...

CMS’ Medicare Beneficiary Identifier initiative and its Medicare Secondary Payer impact

Starting in April, the Centers for Medicare and Medicaid Services (CMS) will begin replacing all Medicare cards with a new unique 11-byte Medicare Beneficiary Identifier (MBI) number. The change is...

Texas Court: Medicare Advantage Plans Can Sue for Private Cause of Action under the Medicare Secondary Payer Statute

In Humana v. Shrader , 2018 WL 1384529 (S.D. Tex. March 16, 2018), the federal district court ruled, in part, that the private cause of action (PCA) provision under the Medicare Secondary Payer (MS...

Medicare Advantage Update: Connecticut Court Rules MAPs Can Pursue “Double Damages” Under the Medicare Secondary Payer Statute

Connecticut is the latest jurisdiction to address whether Medicare Advantage Plans (MAPs) have private cause of action (PCA) rights to pursue “double damages” under the Medicare Secondary Payer (MS...