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.
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.
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
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
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’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’s Section 111 NGHP Unsolicited Response File “opt-in” process (starts July 2023) – Q&A resource (updated)
(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) has released an updated Section 111 NGHP User Guide regarding Section 111 reporting related to non-group health plans.
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.
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.
CMS has made various updates to different aspects of its WCMSA process, including removing the time limit on Amended Reviews.
CMS to hold a Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File Webinar on Tuesday June 6, 2023
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”
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).