Section 111 reporting used to be viewed as an abstract technical Medicare compliance obligation & IT's responsibility because of the data transmission.
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.
When challenging Medicare conditional payment claims, parties must exhaust Medicare administrative appeals before filing an action in federal court.
Shawn Deane, vice president of Medicare / Medicaid compliance and policy, has been elected president of the National Alliance for Medicare Set-Aside Professionals.
To comply with the Medicare Access and CHIP Reauthorization Act of 2015, CMS announced the Social Security Number Removal Initiative on Tuesday, January 17.
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.
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…
The Centers for Medicare and Medicaid Services (CMS) will conduct a town hall teleconference November 17, 2016.
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…
Insurers seeking appeals of adverse conditional payment decisions are finding that their cases are dragging.
On September 22, Congressmen Tim Murphy (R-PA) and Ron Kind (D-WI) introduced legislation designed to clarify the Medicare Secondary Payer (MSP).
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.
New ruling likely to lead to more MAP lien claims against PIP insurers.
Liability claims are particularly at risk, as these emerging compliance issues impose new burdens on the management and settlement of claims.
Undoubtedly, the 11th Circuit Court decision in Humana has obvious financial consequences to insurers.