Claims

8/22/2024 - 1 min read

CMS to hosts Section 111 NGHP Webinar – September 12th at 1:00 p.m. ET

CMS to host a Section 111 NGHP webinar, featuring reporting best practices and a Q&A session.

8/21/2024 - 2 min read

New WCMSA Self-Admin Tool Kit – CMS updates on MAP and Part D plans

CMS releases updated WCMSA Self-Administration Tool Kit (v1.6), with key updates on Medicare Part C, MAP, and Part D plans.

8/21/2024 - 6 min read

New WCMSA Reference Guide (V 4.1) focuses on Medicare Advantage and Part D

CMS' new WCMSA Reference Guide (v4.1) outlines WCMSA coordination with other health insurers.

8/19/2024 - 2 min read

Drive Auto Claims Efficiency with Claims Coverage Identifier

Explore how this dynamic report solves industry challenges, revolutionizing auto claims with streamlined operations and enhanced efficiency

7/30/2024 - 5 min read

Spotlight on WCMSAs – Nutshell Resource

How to prepare for CMS’ new TPOC reporting requirements – Nutshell resource summary.

7/30/2024 - 15 min read

Spotlight on WCMSAs - preparing for CMS' new TPOC reporting requirements

Starting April 4, 2025, CMS requires Section 111 RREs to report specific WCMSA data for all Medicare beneficiary settlements in TPOC reporting.

7/18/2024 - 2 min read

Mid-Year “Round-Up” 2024 – tracking Medicare and claims updates

Stay updated on 2024’s key claim trends: Medicare changes, Section 111 penalties, TPOC/WCMSA reporting, MSAs, FROI/SROI, TPLF, and more.

7/9/2024 - 3 min read

Section 111 NGHP User Guide (V7.6): updates "cumulative injury" definition & TIN errors

CMS releases new Section 111 NGHP User Guide (V7.6) for NGHPs (liability, no-fault, and workers’ compensation) reporting.

7/2/2024 - 0 min read

U.S. Supreme Court overturns Chevron – impacts agency rule challenges.

The U.S. Supreme Court's decision to overturn Chevron deference in Loper Bright Enterprises v. Raimondo (2024), will impact agency rules.

6/27/2024 - 15 min read

Louisiana enacts new Third-Party Litigation Funding (TPLF) law

Louisiana Governor signs Senate Bill 355 (S.B. 355) adding two new chapters to Louisiana’s Revised Statutes.

6/17/2024 - 21 min read

The U.S. District Court for Maryland rules that MAPs can sue insurers for “double damages"

Maryland District Court: MAPs and related entities can sue insurers for "double damages" under the MSP statute's PCA provision.

4/26/2024 - 14 min read

CMS holds a TPOC/WCMSA “Question & Answer” session to further discuss its new Section 111 reporting process

On April 25th, CMS held a “Q and A” session to discuss its plans to require S.111 RREs to report various WCMSA data points as part of its TPOC reporting trigger.

4/16/2024 - 2 min read

CMS releases updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide

CMS has released an updated MSPRP User Guide Version which includes several updates, including the ability to find appeals status updates and updated operating hours for Experian.

4/15/2024 - 1 min read

CMS releases WCMSA Reference Guide Version 4.0

CMS has released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 4.0, April 1, 2024).

4/10/2024 - 11 min read

Governor Justice signs S.B. 850 into law amending West Virginia’s TPLF statutes

On March 27, the West Virginia Governor signed the Updating Consumer Credit and Protection Act into law. This law makes amendments to West Virginia’s existing TPLF statutes.