VISUALIZE | INSIGHTS THAT POWER INNOVATION

ISO Claims Partners

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April 21, 2020

CMS’s Section 111 civil money penalties comment period closes

With the comment period closed, the focus now turns to when CMS will issue its Final Rule, which will comprise of the agency’s official CMP regulations. 

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April 9, 2020

Medicare enables COVID-19 ICD-10 code for Section 111 reporting

The CDC issued a bulletin advising it is implementing the new ICD-10 U07.1 for “COVID-19, virus identified” in an off-cycle update effective 4/1/20, to code the COVID-19…

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April 6, 2020

COVID-19 – ISO Claims Partners keeping you updated

As the industry (and nation) continue to deal with the challenges of the current health crisis, ISO Claims Partners wanted to provide you with some resources which you…

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March 30, 2020

Settling claims in unsettling times

In a time of social distancing and uncertainty, many are left wondering how our current working and social paradigm will impact workers’ compensation claims handling –…

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March 30, 2020

Social Security Administration suspends processing of third-party requests to determine SSDI status

As of 3/17/20, all the Social Security Administration field offices have been closed to the public in response to the growing COVID-19 pandemic according to its website.…

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March 23, 2020

Starting April 25, 2020, CMS will use the 2017 CDC life table for WCMSAs

In an alert dated 3/17/20, CMS announced beginning 4/25/20, it will use the new 2017 CDC life table to calculate adjusted life expectancies in Workers’ Compensation…

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March 6, 2020

CMS releases town hall question/answer document

The Centers for Medicare and Medicaid Services (CMS) has released a question/answer document in follow up to its January 14, 2010 town hall call.

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February 27, 2020

The Eleventh Circuit rules that the MSP’s three-year “claims-filing” statute is not a prerequisite for filing a private cause of action recovery claim

In reversing a lower court decision, the U.S. Circuit Court of Appeals (Eleventh Circuit) in MSPA Claims 1, LLC v. Kingsway Amigo Insurance ruled compliance with the…

Pepi Stojanovski Mjsfnz8baxw Unsplash
February 18, 2020

CMS’s Section 111 penalty proposals are here

CMS has released its long-awaited Section 111 civil money penalty proposals for non-group health plans, as well as group health plans.

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February 12, 2020

CMS releases new NGHP Section 111 User Guide (Version 5.8)

CMS has released an updated Section 111 User Guide (Version 5.8, January 31, 2020) regarding non-group health plans (liability, no-fault and workers’ compensation).

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February 12, 2020

California spotlight: Medicare Advantage recovery rights

The issue of Medicare Advantage Plans recovery rights has catapulted to the compliance forefront over the past few years following a series of court rulings finding that…

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January 21, 2020

CMS holds town hall call to discuss NGHP conditional payment recovery issues

On 1/14/20, CMS held a call to discuss recovery issues related to the Commercial Repayment Center and on-going responsibility for medicals with respect to non-group…

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January 10, 2020

Philadelphia law firm reaches settlement with U.S. Department of Justice regarding alleged failure to resolve Medicare conditional payments

The United States Department of Justice (DOJ), United States Attorney’s Office for the Eastern District of Pennsylvania has issued a news release reporting that a…

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December 17, 2019

Ohio court rules that Medicare Advantage Plans can sue insurers for “double damages” under the MSP

The U.S. District Court in Ohio ruled MAPs can sue insurers for “double damages” under the MSP and the three-year claims filing period doesn’t create a statutory…

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December 9, 2019

CMS to host town hall meeting to discuss CRC ORM recovery issues related to NGHP claims

CMS announced it will host a town hall meeting on recovery issues related to the CRC and on-going responsibility for medicals for non-group health claims.