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Conditional Payments

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April 14, 2022

CMS discusses the MSPRP’s “go paperless” function at recent webinar

CMS held a webinar to discuss the Medicare Secondary Payer Recovery Portal’s (MSPRP’s) “Go Paperless” function.

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March 11, 2022

Medicare Secondary Payer recovery debts can now be paid using automated clearing house transactions

CMS has released a notice advising that MSP recovery debts may now be paid using ACH transactions.

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December 16, 2021

CMS retains its $750 “Low Dollar” threshold for 2022

The Centers for Medicare and Medicaid Services (CMS) has released its 2022 low dollar reporting and recovery threshold via a new alert.

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April 5, 2021

CMS holds BCRC and CRC NGHP Town Hall session

The Centers for Medicare and Medicare Services held what it billed as a Benefits Coordination & Recovery and Commercial Repayment Center non-group health plan Town Hall.

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December 11, 2020

CMS holds NGHP beneficiary recovery process webinar

On 12/9, CMS held a non-group health plan beneficiary recovery process webinar aimed at attorneys who represent beneficiaries and other beneficiary representatives.

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November 30, 2020

CMS retains $750 low dollar threshold for 2021

CMS has announced it is retaining its current $750 low dollar threshold for 2021.

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November 10, 2020

Medicare conditional payment round-up

CMS has been quite active this year announcing several updates to its Medicare Secondary Payer Recovery Portal and holding a recent webinar on redetermination requests

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October 8, 2020

CMS releases updated Medicare Secondary Payer Recovery Portal user guide

On 10/5/20, CMS released an updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide. The changes update the claims listing interface to provide additional…

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September 28, 2020

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…

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September 10, 2020

11th Circuit rules Medicare Advantage downstream entities can sue for double damages under MSP’s PCA provision

The 11th Circuit has ruled “downstream entities”, which Medicare Advantage Plans contract with to help provide benefits, can sue primary plans for “double damages.”

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August 25, 2020

U.S. Department of Justice and plaintiff law firm reached a settlement to resolve a Medicare conditional payment claim

The DOJ’s Attorney’s Office for the Middle District of Pennsylvania has settled a Medicare conditional payment claim with the plaintiff law firm.

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July 14, 2020

CMS releases updated Medicare Secondary Payer Recovery Portal (MSPRP) user guide (Version 4.9)

CMS has released an updated Medicare Secondary Payer Recovery Portal User Guide (Version 4.9, July 13, 2020). CMS has made multiple updates to the MSPRP, which the agency…

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June 16, 2020

Key changes to Michigan PIP start July 1, 2020 – Medicare Secondary Payer compliance impact

While individuals will still be able to elect unlimited PIP coverage, for applicable policies issued or renewed after 7/1/20, PIP plans with different coverage limits may…

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June 3, 2020

CMS to enhance its MSPRP to allow authorized users to view and print conditional payment correspondence

Starting July 13, 2020, authorized MSPRP users will be allowed to view and print CMS conditional payment correspondence.

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May 11, 2020

Court dismisses law firm’s attempt to interplead HHS to resolve Medicare’s conditional payment claim

The United States District Court for the Western District of Missouri in Fowler Pickert LLC v. Glasgow, et. al., 2020 WL 1955266 (W.D. Missouri, April 23, 2020) had to…

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