VISUALIZE | INSIGHTS THAT POWER INNOVATION

Medicare Secondary Payer (MSP)

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May 22, 2017

New realities: The Section 111 connection to conditional payments and claim outcomes

Section 111 reporting used to be viewed as an abstract technical Medicare compliance obligation & IT's responsibility because of the data transmission.

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May 17, 2017

Risky business: Five essential tips for Section 111 reporting

Your Section 111 reporting program may seem clear-cut, but it can mean risky business if your team isn’t prepared to avoid common compliance mistakes.

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April 26, 2017

Exhaust administrative remedies before challenging Medicare conditional payment claims

When challenging Medicare conditional payment claims, parties must exhaust Medicare administrative appeals before filing an action in federal court.

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February 17, 2017

Shawn Deane will lead industry initiatives as president of NAMSAP

Shawn Deane, vice president of Medicare / Medicaid compliance and policy, has been elected president of the National Alliance for Medicare Set-Aside Professionals.

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January 18, 2017

Important SSNRI news at CMS forum

To comply with the Medicare Access and CHIP Reauthorization Act of 2015, CMS announced the Social Security Number Removal Initiative on Tuesday, January 17.

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January 10, 2017

Breaking: CMS recovery practice ruled improper under the MSP

In CIGA v. Burwell, the court ruled the CMS practice of seeking full reimbursement of a medical provider's single charge was improper under the MSP statute.

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November 11, 2016

Removing roadblocks to settlements: Medicare Part C claims in the way of your settlement

The last half-dozen years have seen Medicare Secondary Payer (MSP) compliance evolve, with the most recent example being its change in focus from mandatory insurer…

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November 10, 2016

CMS to hold town hall call on November 17

The Centers for Medicare and Medicaid Services (CMS) will conduct a town hall teleconference November 17, 2016.

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October 19, 2016

CMS updates Medicare Secondary Payer Recovery Portal

On October 11, 2016, the Centers for Medicare and Medicaid Services (CMS) released a new, updated version of the Medicare Secondary Payer Recovery Portal (MSPRP) User…

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October 10, 2016

Conditional payment disputes mired in Medicare appeals backlog

Insurers seeking appeals of adverse conditional payment decisions are finding that their cases are dragging.

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September 29, 2016

The SPARC Act may have implications for future Medicare Advantage Plan rulings

On September 22, Congressmen Tim Murphy (R-PA) and Ron Kind (D-WI) introduced legislation designed to clarify the Medicare Secondary Payer (MSP).

Binders
September 16, 2016

Should you purchase MSA liability insurance?

Medicare Set-Asides (MSAs) are primarily a coordination of benefits tool. The failure to obtain & adequately fund an MSA can result in a denial of payment.

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September 8, 2016

Medicare Advantage Plans allowed to sue no-fault carriers for private cause of action

New ruling likely to lead to more MAP lien claims against PIP insurers.

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August 19, 2016

Preparing for a fundamental compliance shift in liability claims

Liability claims are particularly at risk, as these emerging compliance issues impose new burdens on the management and settlement of claims.

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August 18, 2016

MSP statute extends its reach in the 11th Circuit: Foreshadowing for liability MSAs?

Undoubtedly, the 11th Circuit Court decision in Humana has obvious financial consequences to insurers.