Medicare Secondary Payer (MSP)
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
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.
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.
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
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
CMS to hold Section 111 Webinar on November 13th – CMS to discuss expansion of TPOC reporting to include WCMSA information
CMS’s webinar notice, this session will focus on the expansion of TPOC reporting to include workers’ compensation Medicare set-asides (WCMSA).
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.
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
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.
CMS announces increase to Maximum Settlement Amount for Fixed Percentage Demand Calculation Option starting October 2, 2023
CMS has announced that effective October 2, 2023, the maximum total settlement amount for the Fixed Percentage Demand Calculation Option.
The Minnesota Supreme Court rules that a TPLF agreement’s 60% “repurchase rate” is not subject to MN’s usury statute; remands case back to the district court to determine if this rate is “unconscionable” (and, thus unenforceable) under common-law
One of the issues regarding TPLF concerns whether the interest rates charged by litigation funders can be considered excessive, or legally unenforceable.
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
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
The United States District Court for Connecticut dismisses a Medicare Advantage claim for “double damages” – rules that insurer’s Section 111 reporting not sufficient to establish standing
Interesting new Medicare Advantage recovery case, the United States District Court for Connecticut in MSP Recovery Claims, Series LLC v. Travelers Indemnity Company
The RAMP Act is re-introduced in Congress – bill proposes revisions to the MSP’s private cause of action (“double damages”) provision
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.