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Centers for Medicare & Medicaid Services (CMS)

Important Cms Alert Teaser
September 28, 2023

OIRA issues new notice regarding Section 111 civil money penalties - notice addresses the proposed rule’s economic impact designation

As many will recall, earlier this year the (CMS) extended the timeline to release its Section 111 civil money penalties (CMP) “Final Rule” until February 18, 2024.

Ebmsa Teaser
August 29, 2023

Revisiting indemnified EBMSAs – questions, issues, and risks in a post-Section 4.3 world

Section 4.3, CMS outlined its policy and the potential risks associated with settling a workers’ compensation claim with an EBMSA or Non-Submit MSA.

Court Of Justice Ma
August 10, 2023

United States District Court for Massachusetts rules that a MAP assignee has standing

New Medicare Advantage recovery case, the US District Court for MA in MSP Recovery Claims Series 44, LLC v. Bunker Hill Insurance Company, 2023 WL 4744739 two questions

Cms Releases August Teaser
August 8, 2023

CMS releases NGHP User Guide (Version 7.3) – updates include changes to the ORM trigger and CMS’s Unsolicited Response File process

The (CMS) has released an updated Section 111 NGHP User Guide (Version 7.3, August 7, 2023) regarding Section 111 reporting related to non-group health plans

Mid Year Legal Review Teaser
June 28, 2023

Mid-Year “Round-Up” 2023 – keeping track of Medicare and other claims updates (ICYMI)

We are at the mid-point for 2023! It has been a busy year in so many claims areas. Time to regroup on the key claims updates over the past months – ICYMI style!

Cms Section Teaser
June 27, 2023

CMS’s Section 111 NGHP Unsolicited Response File “opt-in” process – Nutshell Summary Resource

CMS’s Section 111 NGHP Unsolicited Response File “opt-in” process – Nutshell Summary Resource. The following “Nutshell Summary” is a general summary of this process.

Understanding Cms Teaser
June 27, 2023

Understanding CMS’s Section 111 NGHP Unsolicited Response File “opt-in” process (starts July 2023) – Q&A resource (updated)

Understanding CMS’s Section 111 NGHP Unsolicited Response File “opt-in” process (starts July 2023) – Q&A resource (updated)

Cms Blog June Teaser
June 7, 2023

CMS holds webinar to discuss the Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File “opt-in” feature (starts July 2023) and other Section 111 items

(CMS) held a webinar where the agency discussed its upcoming Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File “opt-in” feature (starts July 2023)

Cms Releases Section 111 Teaser
June 7, 2023

CMS releases Section 111 NGHP User Guide (Version 7.2, June 5, 2023) – new changes include: NGHP Unsolicited Response File, ORM reporting trigger, ORM termination, and HEW software

(CMS) has released an updated Section 111 NGHP User Guide regarding Section 111 reporting related to non-group health plans.

The Ramp Act
June 7, 2023

The RAMP Act is re-introduced in Congress – bill proposes revisions to the MSP’s private cause of action (“double damages”) provision

On 5/16/23, (RAMP) Act was re-introduced into the U.S. House of Representatives, bill proposes revisions to the MSP’s private cause of action provision.

Gavel on a white background with a small shadow.
May 23, 2023

The United States District Court for Massachusetts dismisses a Medicare Advantage claim for “double damages” – rules that insurer’s Section 111 reporting does not establish standing to sue

The U.S. District Court for Massachusetts dismisses Medicare Advantage claim for “double damages”—rules insurer’s Section 111 reporting doesn't establish standing to sue.

Wcsma Version Release
May 18, 2023

CMS releases the WCMSA Reference Guide Version 3.9

CMS has made various updates to different aspects of its WCMSA process, including removing the time limit on Amended Reviews.

Cms Nghp Webinar Teaser
May 16, 2023

CMS to hold a Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File Webinar on Tuesday June 6, 2023

CMS to hold a Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File Webinar on Tuesday June 6, 2023

Cmss Nghp Unsolicited Response Teaser
May 16, 2023

CMS’s NGHP Unsolicited Response File “opt-in” process starts in July 2023 – Q&A, issues, and considerations

Earlier this year (CMS) formally announced a new non-group health plan (NGHP) Unsolicited Response File “opt-in” feature. Per CMS, this new process starts “July 2023”

Cms Releases Non Group Teaser
May 3, 2023

CMS releases Non-Group Health Plan (NGHP) Applicable Plan Appeals Reference Guide (Version 1.0)

The Centers for Medicare and Medicaid Services (CMS) has released a Non-Group Health Plan (NGHP) Applicable Appeals Reference Guide (Version 1.0, April 27, 2023).

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