This brief government shutdown did not affect Medicare Secondary Payer operations as they are essential and considered part of the Medicare Integrity Program. Thus,…
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)…
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…
CMS has announced that it is maintaining the current $750.00 low dollar threshold in 2018 for certain settlement, judgments, awards or other payments.
Whether liability Medicare set-asides (LMSAs) are legally “required” continues to be a vexing question for parties settling liability claims.
On October 26, 2017, the Centers for Medicare and Medicaid Services (CMS) has released its latest update regarding the LMSA issue.
The recent passage of Arizona Senate Bill (S.B.) 1332 provides Arizona claims payers with unprecedented opportunity to close out their workers' comp claims.
A new case out of Connecticut highlights complications insurers can encounter in obtaining information to assess their MSP compliance obligations.
Section 111 reporting used to be viewed as an abstract technical Medicare compliance obligation & IT's responsibility because of the data transmission.
When challenging Medicare conditional payment claims, parties must exhaust Medicare administrative appeals before filing an action in federal court.
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.
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.
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.
The Centers for Medicare and Medicaid Services (CMS) has released its latest alert regarding its low-dollar reporting and recovery thresholds pertaining to liability…
Medicare calculated its recently revised “low-dollar” recovery and reporting thresholds for liability, workers compensation and no-fault settlements.