Section 111

CMS Releases New NGHP Section 111 User Guide

The Centers for Medicare and Medicaid Services (CMS) has updated its  Non-Group Health Plan (NGHP) Section 111 User Guide . The new guide is styled as Version 5.5 and is dated January 7, 2019. Per...

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. The improvements discuss...

CMS Preparing to Address Section 111 Reporting Penalties

The Office of Management and Budget (OMB) has issued a notice entitled Civil Money Penalties and Medicare Secondary Payer Reporting Requirements (CMS-6061-P) indicating that the Centers for Medicar...

CMS Releases New WCMSA Reference Guide and NGHP Section 111 User Guide

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

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, finally, to close out their workers’ compensation claims. Under this new law, parties will now be able to reach “full and final” settlement of certain workers’ compensation claims beginning October 31, 2017.

Medicare Section 111 Process Change Eases One Compliance Burden

Medicare’s annual recertification process and update brings welcome news about Section 111 reporting and Responsible Reporting Entities (RREs). RREs will no longer automatically be moved into...

New Realities: The Section 111 Connection to Conditional Payments and Claim Outcomes

Section 111 reporting historically has been viewed as an abstract technical Medicare compliance obligation and the responsibility of an IT department, because it involves the electronic transmissio...

Risky Business: Five Essential Tips for Section 111 Reporting

Your Section 111 reporting program may seem clear-cut, but it can mean risky business if your team isn’t prepared to avoid the pitfalls of common compliance mistakes. The primary objective of Secti...

CMS Releases Updated Reporting and Recovery Thresholds with News on TPOCs

The Centers for Medicare and Medicaid Services (CMS) has released its latest alert regarding its low-dollar reporting and recovery thresholds pertaining to liability (including self-insurance),...