Conditional Payments
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.
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.
Claims commitment: Empowering insurers on the innovation journey
The insurance industry has experienced tremendous change in the past few years.
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.
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.
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.
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.
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.
CMS retains $750 low dollar threshold for 2021
CMS has announced it is retaining its current $750 low dollar threshold for 2021.
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
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…
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…
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.”
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.
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…