SMART Act

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...

Conditional payment disputes mired in Medicare appeals backlog

Insurers seeking appeals of adverse conditional payment decisions are finding that their cases are dragging, thanks to a major backlog of pending Medicare appeal requests. The Strengthening Medicar...

CMS Releases New Final Rule: Expedited Conditional Payment Process

On May 17, the Centers for Medicare and Medicaid Services (CMS) released its final rule on the SMART Act’s interim conditional payment process through the Federal Register, and insurers will want t...

Medicare Conditional Payment Compliance: Myth vs. Fact

The statutes and regulations that govern Medicare have been referred to by courts as “ the most completely impenetrable texts within human experience .” With the complex nature of Medicare complian...