Medicare

Exhaust Administrative Remedies Before Challenging Medicare Conditional Payment Claims

A new case out of Missouri reaffirms this important principle: When challenging Medicare conditional payment claims, parties must exhaust Medicare administrative appeals before filing an action in...

Clues to CMS future gleaned from WCRC solicitation notice

The Centers for Medicare & Medicaid Services (CMS) moved forward with requests for proposal regarding the Workers’ Compensation Review Contractor (WCRC) contract by releasing a full solicitation...

Important SSNRI News at CMS Forum

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires the Centers for Medicare & Medicaid Services (CMS) to remove Social Security numbers (SSNs) from Medicare cards before the...

New Report Reveals Medicare’s “Low-Dollar” Threshold Calculations

U.S. Secretary of Health and Human Services (HHS) Sylvia Mathews Burwell released a new report to Congress that provides insight into the data the Centers for Medicare and Medicaid Services (CMS)...

Removing Roadblocks to Settlements: Medicare Part C Claims in the Way of Your Settlement

The last half-dozen years have seen Medicare Secondary Payer (MSP) compliance evolve, with the most recent example being its change in focus from mandatory insurer reporting to rolling recovery. Bu...

CMS to Hold Town Hall Call on November 17

The Centers for Medicare and Medicaid Services (CMS) will conduct a Town Hall Teleconference November 17, 2016 (1:00 p.m. – 2:30 p.m. EST) to address numerous liability insurance (including...

CMS Updates Medicare Secondary Payer Recovery Portal

On October 11, 2016, the Centers for Medicare and Medicaid Services (CMS) released a new, updated version of the Medicare Secondary Payer Recovery Portal (MSPRP) User Guide. As many of our readers...

The SPARC Act may have implications for future Medicare Advantage Plan rulings

On September 22, Congressmen Tim Murphy (R-PA) and Ron Kind (D-WI) introduced legislation designed to clarify the Medicare Secondary Payer (MSP) standing on Medicare Part D plans. Text of the new...

Should You Purchase MSA Liability Insurance?

It’s estimated that the number of Medicare beneficiaries will reach 80 million by 2030. When it comes to Medicare Secondary Payer (MSP) compliance, enforcement will likely increase as the number of...

New WCRC contract bid could indicate expansion of MSAs beyond workers' compensation

On September 6, the Centers for Medicare and Medicaid Services (CMS) updated a previously released pre solicitation notice regarding a new contract for the Workers’ Compensation Review Contractor...