Sid Wong, J.D.
New NGHP Section 111 User Guide (6.4) – PAID Act, ORM termination, and other updates
The Centers for Medicare and Medicaid Services (CMS) has released an updated Section 111 NGHP User Guide (Version 6.4, June 11, 2021) regarding non-group health plans.
CMS releases new WCMSA Reference Guide (Version 3.3)
The Centers for Medicare and Medicaid Services (CMS) has just released their latest version of the WCMSA Reference Guide (Version 3.3, April 19, 2021).
Starting March 27, 2021, CMS will use the 2018 CDC Life Table for WCMSAs
Starting 3/27/21, CMS has announced that it will use the new 2018 CDC Life Table to calculate adjusted life expectancies in Workers’ Compensation Medicare Set-Asides…
CMS releases new WCMSA Reference Guide (Version 3.2)
On 10/5/20, CMS released its latest version of the WCMSA Reference Guide, Version 3.2. This guides replaces version 3.1, released on 5/11/20.
CMS discusses conditional payment issues on NGPH applicable plans webinar
On 9/24, CMS and the CRC held a webinar on redetermination requests as part of the administrative appeals process for conditional payment disputes of non-group health…
CMS releases new WCMSA reference guide (Version 3.1)
The Centers for Medicare and Medicaid Services (CMS) has just released its latest version of the WCMSA reference guide version 3.1 (May 11, 2020).
Medicare enables COVID-19 ICD-10 code for Section 111 reporting
The CDC issued a bulletin advising it is implementing the new ICD-10 U07.1 for “COVID-19, virus identified” in an off-cycle update effective 4/1/20, to code the COVID-19…
Settling claims in unsettling times
In a time of social distancing and uncertainty, many are left wondering how our current working and social paradigm will impact workers’ compensation claims handling –…
Social Security Administration suspends processing of third-party requests to determine SSDI status
As of 3/17/20, all the Social Security Administration field offices have been closed to the public in response to the growing COVID-19 pandemic according to its website.…
Starting April 25, 2020, CMS will use the 2017 CDC life table for WCMSAs
In an alert dated 3/17/20, CMS announced beginning 4/25/20, it will use the new 2017 CDC life table to calculate adjusted life expectancies in Workers’ Compensation…
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.
CMS holds town hall call to discuss NGHP conditional payment recovery issues
On 1/14/20, CMS held a call to discuss recovery issues related to the Commercial Repayment Center and on-going responsibility for medicals with respect to non-group…
CMS to host town hall meeting to discuss CRC ORM recovery issues related to NGHP claims
CMS announced it will host a town hall meeting on recovery issues related to the CRC and on-going responsibility for medicals for non-group health claims.
CMS releases new WCMSA Reference Guide (Version 3.0)
CMS has released a revised Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.0, October 10, 2019).
CMS releases WCMSA Self-Administration Toolkit 1.3
CMS has released the latest edition of its Self-Administration Toolkit for Workers’ Compensation Medicare Set-Aside Arrangements (Version 1.3; October 10, 2019).