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...

Comply with Medicaid Reporting Requirements: It Only Takes a Signature

Earlier this year, Rhode Island passed Article 11, as part of Title 27, Chapter 57.1-1 — the Medical Assistance Intercept Act — which requires all insurers that write workers' compensation or...

Help Us Help You Comply with Medicaid Reporting Requirements

As the leading provider of insurance claims services, we're dedicated to educating clients about new state and federal regulations. Please visit our information page to learn about the mandatory...