Conditional Payments

Colleagues Conversing Around Conference Table 3

3/13/2025 - 18 min read

Section 111 reporting: CMS’s road map to conditional payment recovery

Insurers must understand CMS's use of Section 111 data in the conditional payment recovery process to avoid consequences and liability.

7/18/2024 - 2 min read

Mid-Year “Round-Up” 2024 – tracking Medicare and claims updates

Stay updated on 2024’s key claim trends: Medicare changes, Section 111 penalties, TPOC/WCMSA reporting, MSAs, FROI/SROI, TPLF, and more.

12/7/2023 - 11 min read

Breaking down CMS’s plans to capture WCMSA data

CMS has announced plans to require Section 111 RREs to report various data points related to WCMSA arrangements

11/7/2023 - 15 min read

CMS releases new Section 111 penalties FAQ resource

CMS has now released a new Alert entitled CMS’s Medicare Secondary Payer and Certain Civil Money Penalties: Frequently Asked Questions

10/11/2023 - 24 min read

CMS's Section 111 penalties "final rule" released

In an important development, CMS has released its Section 111 penalties “Final Rule” --- CMS penalties will go live in 60 days.

9/18/2023 - 4 min read

CMS announces increase to Maximum Settlement Amount for Fixed Percentage Demand Calculation Option starting October 2, 2023

CMS has announced that effective October 2, 2023, the maximum total settlement amount for the Fixed Percentage Demand Calculation Option.

1/11/2023 - 22 min read

Understanding Medicare Treasury claims – avoiding the pitfalls and steps for success

In this article, the author provides a general overview of Treasury collection actions in relation to CMS’s non-group health plan recovery process.

12/15/2022 - 4 min read

CMS retains its $750 “Low Dollar” threshold for 2023

The Centers for Medicare and Medicaid Services (CMS) has released its 2023 low dollar reporting and recovery threshold.

6/30/2022 - 2 min read

Claims commitment: Empowering insurers on the innovation journey

The insurance industry has experienced tremendous change in the past few years.

4/14/2022 - 4 min read

CMS discusses the MSPRP’s “go paperless” function at recent webinar

CMS held a webinar to discuss the Medicare Secondary Payer Recovery Portal’s (MSPRP’s) “Go Paperless” function.

3/11/2022 - 1 min read

Medicare Secondary Payer recovery debts can now be paid using automated clearing house transactions

CMS has released a notice advising that MSP recovery debts may now be paid using ACH transactions.

4/5/2021 - 7 min read

CMS holds BCRC and CRC NGHP Town Hall session

The Centers for Medicare and Medicare Services held what it billed as a Benefits Coordination & Recovery and Commercial Repayment Center non-group health plan Town Hall.

12/11/2020 - 4 min read

CMS holds NGHP beneficiary recovery process webinar

On 12/9, CMS held a non-group health plan beneficiary recovery process webinar aimed at attorneys who represent beneficiaries and other beneficiary representatives.

11/30/2020 - 6 min read

CMS retains $750 low dollar threshold for 2021

CMS has announced it is retaining its current $750 low dollar threshold for 2021.

11/10/2020 - 6 min read

Medicare conditional payment round-up

CMS has been quite active this year announcing several updates to its Medicare Secondary Payer Recovery Portal and holding a recent webinar on redetermination requests