Medicaid

Budget Act of 2018 Limits Medicaid Third-Party Recovery Rights

President Trump signed a budget deal early February 9 th following a brief government shutdown while most Americans were fast asleep. While most of the headlines focused on the deal’s impact on...

Now Hear This: Medicaid Secondary Payer Recovery on the Rise

Up until now, Medicaid lacked the kind of mechanisms that Medicare has adopted for identifying and seeking payment recovery from responsible third parties. Yet, from a federal perspective, Medicaid...

Expansion of Medicaid Secondary Payer Poses New Compliance Challenges

After numerous delays, it appears inevitable that the expansion of Medicaid Secondary Payer rights will begin on October 1, 2017. The 2013 Bipartisan Budget Act (H.J. Res. 59; Pub. L. 113–67) included the provision to enable states to recover Medicaid expenditures from an entire settlement amount, rather than just those dollars apportioned to medical expenses, as previously held by case law. However, legislative delays resulted in implementation being postponed from October 1, 2014, to this year.

Conditional Payments Update: Thousands of letters and notices issued

In a brief alert issued on February 11, 2016, the Centers for Medicare and Medicaid Services (CMS) announced that since the October transition of conditional payment recovery from the Benefits...

Medication Trends to Watch

It’s no surprise that prescription medications are often the biggest cost driver in a Medicare Set-Aside (MSA). Physicians routinely prescribe costly medications to treat claimants’ injuries and...

CMS Releases Training Document Regarding RX Drugs and the WCMSA Portal

The Centers for Medicare and Medicaid Services (CMS) has released a training document regarding its upcoming plans to allow prescription drug information to be entered directly into the WCMSA Porta...

Preparing for the ICD-10 Transition

The Centers for Medicare and Medicaid Services (CMS) released an alert in May 2014 announcing that the ICD-10 diagnosis codes reporting for Section 111 is postponed until October 1, 2015. A copy of...

Is Cost-Shifting to P&C Payers on the Horizon?

There are numerous provisions of the Affordable Care Act (ACA), aimed at reducing the cost of America’s healthcare. According to Healthcare Finance News , the cost-saving strategies include specifi...

Rhode Island Seeks Further Adoption of Medicaid Reporting

Since 2012, ISO ClaimSearch ® has been working with its membership to increase reporting of qualified claims to the Rhode Island Executive Office of Health and Human Services (EOHHS), as required b...

ISO ClaimSearch Medicaid Reporting Service Sees Brisk Enrollment

ISO developed the ISO ClaimSearch Medicaid Reporting Service to help you respond to the Medicaid reporting and verification requirements in Rhode Island. Rhode Island passed Article 11 as part of...