Casualty Solutions

1/12/2023 - 13 min read

CMS releases Section 111 NGHP User Guide (Version 7.0, January 9, 2023) – CMS announces several new updates to kick off 2023

The (CMS) has released an updated Section 111 NGHP User Guide (Version 7.0, January 9, 2023) regarding Section 111 reporting related to non-group health plans.

1/11/2023 - 22 min read

Understanding Medicare Treasury claims – avoiding the pitfalls and steps for success

In this article, the author provides a general overview of Treasury collection actions in relation to CMS’s non-group health plan recovery process.

1/9/2023 - 7 min read

CMS releases request for proposal for the Workers’ Compensation Review Contractor (WCRC) contract

On January 4, 2023, the Centers for Medicare and Medicaid Services (CMS) issued an RFP for its Workers’ Compensation Review Contractor (WCRC) contract.

12/22/2022 - 14 min read

Is the other “M” on your radar? 5 things to know about Medicaid and how we can help!

It is no secret that Medicare secondary payer compliance issues often dominate the claims landscape and discussion.

12/15/2022 - 4 min read

CMS retains its $750 “Low Dollar” threshold for 2023

The Centers for Medicare and Medicaid Services (CMS) has released its 2023 low dollar reporting and recovery threshold.

12/9/2022 - 17 min read

The PAID Act one year after implementation – How is it going? What are we seeing?

On 12/11/21, the (PAID Act) went live following a year-long implementation roll-out by the Centers for Medicare and Medicaid Services (CMS).

12/7/2022 - 13 min read

CMS discusses various Section 111 reporting issues as part of its NGHP Section 111 Webinar

The Centers for Medicare and Medicaid Services held a non-group health plan Section 111 webinar, in which the agency discussed a wide variety of Section 111 topics.

11/16/2022 - 4 min read

CMS releases updated Workers’ Compensation Medicare Set-Aside Reference Guide (Version 3.8) – changes impact CMS’s WCMSA re-review process

The Centers for Medicare and Medicaid Services (CMS) has released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.8)

11/14/2022 - 1 min read

CMS to hold NGHP Section 111 Webinar on December 6th at 1:00 p.m. ET

The Centers for Medicare and Medicaid Services (CMS) has announced that it will be holding a non-group health plan (NGHP) Section 111 webinar.

11/9/2022 - 14 min read

Back to the drawing board: CMS’s future medicals proposals are withdrawn – where does this leave LMSAs?

As reported in our October update, the Centers for Medicare and Medicaid Services’ (CMS’s) future medicals proposals have been withdrawn.

11/3/2022 - 10 min read

CMS releases data and statistics regarding CRC recoveries and WCMSAs

The Centers for Medicare and Medicaid Services (CMS) has released two new reports providing data regarding CRC recoveries and WCMSAs.

10/31/2022 - 22 min read

U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages” – ruling affirms the district court’s award of double damages against insurer

U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages”

10/14/2022 - 1 min read

CMS’s future medicals proposals have been withdrawn

In an important new development, an updated Office of Information and Regulatory Affairs (OIRA) notice reflects that CMS has withdrawn its “future medicals” proposals.

10/4/2022 - 7 min read

CMS releases Section 111 NGHP User Guide (Version 6.9) – updates relate to Section 111 excluded/valid diagnosis codes for 2023, SP31 error, and other items

9/8/2022 - 4 min read

COVID-19 and Workers’ Compensation in 2022: The Great Resignation and Closing the Talent Gap

We continue our look at how the COVID-19 pandemic continues to impact workers’ compensation.