VISUALIZE | INSIGHTS THAT POWER INNOVATION

Mark Popolizio

Mark Popolizio, J.D., is vice president of MSP compliance at ISO Claims Partners, a Verisk business. You can contact Mark at mpopolizio@verisk.com.

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January 23, 2018

Government shutdown ends – Congress and President reach deal

This brief government shutdown did not affect Medicare Secondary Payer operations as they are essential and considered part of the Medicare Integrity Program. Thus,…

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January 12, 2018

Medicare Advantage Plans update: Illinois court indicates MAPs have “double damages” rights

Whether Medicare Advantage Plans have private cause of action rights to sue claims payers (and others) for “double damages” under the Medicare Secondary Payer (MSP)…

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December 21, 2017

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). This…

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December 4, 2017

CMS maintains its $750 low dollar threshold for 2018

CMS has announced that it is maintaining the current $750.00 low dollar threshold in 2018 for certain settlement, judgments, awards or other payments.

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December 1, 2017

Court declines to rule on whether LMSA is necessary - Cites no legal authority for MSAs in liability cases

Whether liability Medicare set-asides (LMSAs) are legally “required” continues to be a vexing question for parties settling liability claims.

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October 26, 2017

Liability MSA update

On October 26, 2017, the Centers for Medicare and Medicaid Services (CMS) has released its latest update regarding the LMSA issue.

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September 26, 2017

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.

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June 16, 2017

Court blocks Medicare discovery requests - Ruling limits insurer's ability to determine MMSEA obligations

A new case out of Connecticut highlights complications insurers can encounter in obtaining information to assess their MSP compliance obligations.

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May 22, 2017

New realities: The Section 111 connection to conditional payments and claim outcomes

Section 111 reporting used to be viewed as an abstract technical Medicare compliance obligation & IT's responsibility because of the data transmission.

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April 26, 2017

Exhaust administrative remedies before challenging Medicare conditional payment claims

When challenging Medicare conditional payment claims, parties must exhaust Medicare administrative appeals before filing an action in federal court.

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March 20, 2017

2017 Medicare watch list

It’s clear there will be no shortage of Medicare Secondary Payer developments to keep an eye on this year. Here’s an outline of MSP events to watch in 2017.

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March 8, 2017

New development hints at future MSA expansion to liability: CMS updates Common Working File for LMSAs and NFMSAs

CMS has issued a Change Request (CR-9893) to update it's Common Working File regarding both Liability and No-Fault Medicare Set-Aside arrangements.

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January 10, 2017

Breaking: CMS recovery practice ruled improper under the MSP

In CIGA v. Burwell, the court ruled the CMS practice of seeking full reimbursement of a medical provider's single charge was improper under the MSP statute.

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December 16, 2016

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…

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November 14, 2016

New report reveals Medicare’s “low-dollar” threshold calculations

Medicare calculated its recently revised “low-dollar” recovery and reporting thresholds for liability, workers compensation and no-fault settlements.