Section 111 Reporting

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7/15/2019 - 1 min read

CMS releases new NGHP Section 111 user guide (Version 5.6)

On 7/1/19, CMS released an updated Section 111 User Guide (Version 5.6) regarding non-group health plans (liability, no-fault and workers’ compensation).

6/27/2019 - 4 min read

Think about your thresholds: Preventing errors to avoid CMS penalties

One way responsible reporting entities can attempt to achieve full CMS compliance and avoid potential penalties is to closely consider file thresholds.

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6/17/2019 - 6 min read

Big reforms are coming to Michigan PIP - How the changes will impact Medicare Secondary Payer compliance

On 5/30/19, Governor Gretchen Whitmer signed Michigan Senate Bill 1, which makes significant changes to Michigan’s personal injury protection (PIP) system.

6/14/2019 - 6 min read

Avoiding penalty problems by ensuring data accuracy

With CMS (Centers for Medicare and Medicaid Services) penalties on the horizon, we’ve been exploring how RREs (Responsible Reporting Entities) can be proactive in avoiding fines.

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5/31/2019 - 4 min read

To avoid CMS penalty exposure time is of the essence

The timely reporting of ORM and TPOC data to CMS is of key importance to insurers, especially now enforcement of noncompliance penalties is on the horizon.

5/17/2019 - 5 min read

With civil money penalties looming, it’s time to fine-tune CMS reporting

Steering clear of CMS penalties is possible by implementing a meticulous query process and being mindful of the regulations surrounding ongoing medicals and total payment obligations

1/4/2019 - 2 min read

CMS releases new NGHP Section 111 user guide

CMS has updated its Non-Group Health Plan Section 111 User Guide. The new guide is styled as Version 5.5 and is dated January 7, 2019.

12/20/2018 - 3 min read

MSPRP update: CMS announces a new self-reporting option and updates to the multi-factor authentication process

The Centers for Medicare and Medicaid Services (CMS) hosted a webinar focusing on enhancements to its Medicare Secondary Payer Recovery Portal (MSPRP) on December 18, 2018.

10/5/2018 - 2 min read

CMS releases new WCMSA Reference Guide and NGHP Section 111 User Guide

The Centers for Medicare and Medicaid Services (CMS) has updated both its Workers' Compensation Medicare Set-Aside (WCMSA) Reference Guide and its Non-Group Health Plan (NGHP) Section 111 User Guide.

5/22/2018 - 5 min read

Arizona tweaks its "full & final" workers' comp settlement law - New law provides opportunities to settle workers' comp claims

Arizona Senate Bill 1100 provides unprecedented opportunities to settle workers' compensation claims in the state.

2/28/2018 - 7 min read

Medicare watch list: Staying ahead of the Medicare Secondary Payer compliance curve

As another new year settles in, we know at least one thing is certain: MSP compliance will continue to present formidable challenges for claims payers.

1/19/2018 - 4 min read

CMS holds town hall call on CRC transition - CMS provides important updates on ORM recovery transition

On January 18, 2018, CMS held its Commercial Repayment Center Non-Group Health Plan (NGHP) Town Hall presentation to address the upcoming transition of CRC operations from CGI Federal to Performant Financial Corporation.

12/21/2017 - 3 min read

CMS Releases New Section 111 NGHP User Guide (Version 5.3)

The Centers for Medicare and Medicaid Services (CMS) has released an updated Section 111 non-group health plan (NGHP) User Guide (Version 5.3, December 15, 2017).

10/6/2017 - 2 min read

Performant awarded CMS Commercial Repayment Center contract

The Centers for Medicare and Medicaid Services (CMS) awarded Performant Financial Corporation (Performant) the Commercial Repayment Center (CRC) contract.

9/26/2017 - 6 min read

Countdown to “full and final” settlements: Arizona S.B. 1332

The recent passage of Arizona Senate Bill (S.B.) 1332 provides Arizona claims payers with unprecedented opportunity to close out their workers' comp claims.