Centers for Medicare & Medicaid Services (CMS)

12/11/2023 - 1 min read

CMS Announces Updates to the Medicare Secondary Payer Recovery Portal

(CMS) released an alert announcing that in January 2024 a new enhancement will be made to the MSPRP portal

12/7/2023 - 11 min read

Breaking Down CMS’s Plans to Capture WCMSA Data

CMS has announced plans to require Section 111 RREs to report various data points related to WCMSA arrangements

12/5/2023 - 1 min read

CMS to Hold NGHP Section 111 Penalties Webinar

CMS will be holding a Section 111 civil money penalties (CMP) webinar for (NGHPs) on January 18, 2024 at 1:00 p.m. ET.

11/29/2023 - 8 min read

CMS Corrects Minor “Technical Errors” in the Section 111 Penalties

In a new development, CMS has issued an update which corrects certain “technical errors” in the Section 111 final rule.

11/16/2023 - 10 min read

CMS Discusses Plans to Capture WCMSA Data Points as Part of TPOC Reporting During Recent Section 111 Webinar

CMS held a webinar to discuss its plans to require Section 111 (RREs) to report data points related to WCMSAs

11/7/2023 - 15 min read

CMS Releases New Section 111 Penalties FAQ Resource

CMS has now released a new Alert entitled CMS’s Medicare Secondary Payer and Certain Civil Money Penalties: Frequently Asked Questions

10/11/2023 - 24 min read

CMS’s Section 111 Penalties “Final Rule” Released – Breaking Down CMS’s Penalty Provisions and How They Impact Section 111 Reporting

In an important development, CMS has released its Section 111 penalties “Final Rule” --- CMS penalties will go live in 60 days.

10/10/2023 - 2 min read

An Award-Winning Effort Breaks New Ground in Medical Record Review

Verisk leaders earn Technology Innovation honoree status in the 2023 PC360 Insurance Luminary program for their work on Discovery Navigator

9/28/2023 - 16 min read

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.

8/10/2023 - 20 min read

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

8/8/2023 - 9 min read

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

6/28/2023 - 10 min read

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!

6/27/2023 - 5 min read

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.

6/27/2023 - 22 min read

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

6/7/2023 - 11 min read

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)