Mark Popolizio, J.D.
CMS releases updated Medicare Secondary Payer Recovery Portal (MSPRP) user guide (Version 4.9)
CMS has released an updated Medicare Secondary Payer Recovery Portal User Guide (Version 4.9, July 13, 2020). CMS has made multiple updates to the MSPRP, which the agency…
Seven steps to closed: Maximizing claims settlement projects
There's a thin and potentially costly line between settling a claim and keeping it open. Using a claims settlement project can help close claims faster.
Eleventh Circuit rules that Florida Medicaid may seek recovery of its past payments from those portions of the settlement agreement representing past and future medical care
In a new Florida Medicaid decision, the U.S. Circuit Court of Appeals for the Eleventh Circuit, in Gallardo v. Dudek, 2020 ruled Florida Medicaid may seek recovery of…
CMS releases new NGHP Section 111 User Guide (Version 5.9)
CMS has released an updated Section 111 NGHP User Guide (Version 5.9, June 29, 2020) regarding non-group health plans (liability, no-fault and workers’ compensation).
CMS’s expected release of its “future medicals” proposals now scheduled for August 2020
An updated notice from the Office of Information and Regulatory Affairs indicates CMS’s long-anticipated release of its “future medicals” notice of proposed rulemaking is…
Key changes to Michigan PIP start July 1, 2020 – Medicare Secondary Payer compliance impact
While individuals will still be able to elect unlimited PIP coverage, for applicable policies issued or renewed after 7/1/20, PIP plans with different coverage limits may…
CMS releases Section 111 alert regarding the reporting of no-fault insurance and med-pay policy limits on claim input files
Limits on NGHP claim input files in situations where separate Med-Pay and PIP coverages being paid out under a single policy for the same injured party and incident.
Court dismisses law firm’s attempt to interplead HHS to resolve Medicare’s conditional payment claim
The United States District Court for the Western District of Missouri in Fowler Pickert LLC v. Glasgow, et. al., 2020 WL 1955266 (W.D. Missouri, April 23, 2020) had to…
COVID-19 – State by state legislative and regulatory resources
Many insurers are concerned with how COVID-19 related legislative and regulatory changes could impact exposure and liability going forward.
Court finds state of Rhode Island compliant with Section 111 despite its inability to obtain social security information to determine Medicare status and enforces settlement
The U.S. District Court in Ruiz v. Rhode Island was called upon to address whether a personal injury settlement should be enforced even though the defendant was unable to…
CMS’s Section 111 civil money penalties comment period closes
With the comment period closed, the focus now turns to when CMS will issue its Final Rule, which will comprise of the agency’s official CMP regulations.
COVID-19 – ISO Claims Partners keeping you updated
As the industry (and nation) continue to deal with the challenges of the current health crisis,we want to provide you with some resources which you may find helpful.
CMS releases town hall question/answer document
The Centers for Medicare and Medicaid Services (CMS) has released a question/answer document in follow up to its January 14, 2010 town hall call.
The Eleventh Circuit rules that the MSP’s three-year “claims-filing” statute is not a prerequisite for filing a private cause of action recovery claim
In reversing a lower court decision, the U.S. Circuit Court of Appeals (Eleventh Circuit) in MSPA Claims 1, LLC v. Kingsway Amigo Insurance ruled compliance with the…
CMS’s Section 111 penalty proposals are here
CMS has released its long-awaited Section 111 civil money penalty proposals for non-group health plans, as well as group health plans.