Claims

With Civil Money Penalties Looming, It’s Time to Fine-Tune CMS Reporting

For insurance carriers and self-insureds—known as Responsible Reporting Entities (RREs)—Section 111 can be a daunting obligation. In fact, it’s the only Medicare Secondary Payer (MSP) compliance area associated with a...

Reality Check: Debunking the Myths of Medicare Secondary Payer Compliance

Medicare Secondary Payer (MSP) is a challenging area of compliance for which federal law, regulations, and policy don’t always provide clear answers. This often conflicts with the processes and procedures outlined by...

Longshore Act - Medicare Alert: Court Rules that Claimant’s Action for “Double Damages” Was Premature

An interesting new case out of California is a reminder that payers of claims pursuant to the Longshore and Harbor Workers’ Compensation Act (“Longshore Act”) need to stay vigilant for potential “double damages” actio...

Maryland Law Firm Reaches $250,000 Settlement with U.S. Department of Justice to Reimburse Medicare Conditional Payments

The United States Department of Justice (DOJ), United States Attorney’s Office for the District of Maryland has issued a news release reporting that a Maryland personal injury law firm has entered into a settlement fo...

CMS Holds Webinar to Address Plans to Add Electronic Payment Functionality to its Medicare Secondary Payer Recovery Portal

On March 13, 2019, the Centers for Medicare and Medicaid Services (CMS) held a webinar to discuss its plans to add electronic payment functionality to its Medicare Secondary Payer Recovery Portal (MSPRP). The MSPRP...

PAID Act Reintroduced in 116th Congress

On February 26 th , Congressmen Ron Kind (D-WI) and Guy Bilirakis (R-FL) reintroduced the Provide Accurate Information Directly (PAID) Act as H.R. 1375 into the U.S. House of Representatives. This bi-partisan bill was...

Electronic Payment Functionality to be added to the Medicare Secondary Payer Recovery Portal – CMS to hold webinar on March 13, 2019

The Centers for Medicare and Medicaid Services (CMS) announced that effective April 1, 2019, electronic payment functionality will be added to the Medicare Secondary Payer Recovery Portal (MSPRP). The MSPRP relates to...

Top 10 Medicare Secondary Payer Trends in 2019

Medicare Secondary Payer (MSP) compliance is a rapidly evolving area that has experienced significant changes in recent years, and 2019 looks to be no different. Policy changes, stricter regulations, new legislation,...

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, changes were ma...