Medicare Secondary Payer (MSP)

6/17/2019 - 8 min read

Florida court: No-fault pre-suit notice requirement must be followed before Medicare private cause of action claim can proceed

In a new Florida decision, the U.S. District Court in ruled Florida’s no-fault pre-suit notice requirement must be satisfied before a PCA action can proceed.

5/17/2019 - 5 min read

With civil money penalties looming, it’s time to fine-tune CMS reporting

Steering clear of CMS penalties is possible by implementing a meticulous query process and being mindful of the regulations surrounding ongoing medicals and total payment obligations

4/24/2019 - 7 min read

Longshore Act - Medicare alert: Court rules that claimant’s action for “double damages” was premature

Claims payers pursuant to the Longshore Act need to stay vigilant for potential double damages actions under the MSP statute’s private cause of action provision

3/21/2019 - 4 min read

Maryland law firm reaches $250,000 settlement with U.S. Department of Justice to reimburse Medicare conditional payments

A Maryland personal injury law firm settled for $250,000 with the U.S. to resolve allegations it failed to reimburse certain Medicare payments made to medical providers on behalf of a firm client.

3/14/2019 - 2 min read

CMS holds webinar to address plans to add electronic payment functionality to its Medicare Secondary Payer Recovery Portal

On 3/13/19, CMS held a webinar to discuss its plans to add electronic payment functionality to its Medicare Secondary Payer Recovery Portal.

2/27/2019 - 1 min read

Electronic payment functionality to be added to the Medicare Secondary Payer Recovery Portal – CMS to hold webinar on March 13, 2019

CMS announced effective April 1, 2019, electronic payment functionality will be added to the Medicare Secondary Payer Recovery Portal.

2/25/2019 - 1 min read

CMS to mask health insurance claim number and social security number on contractor correspondence starting April 2019

Starting 4/1/19, CMS’s Coordination of Benefits and Recovery Program program will mask the social security number (SSN) and SSN-portion of the health insurance claim number on all ongoing letters.

1/2/2019 - 1 min read

Government shutdown – MSP update

As the partial government shutdown continues, questions are being raised as to the shutdown’s impact on CMS activities concerning Medicare Secondary Payer compliance.

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12/21/2018 - 2 min read

Proposed rules for addressing future medical obligations to be released

The Office of Information and Regulatory Affairs (OIRA) recently issued a notice entitled Miscellaneous Medicare Secondary Payer Clarifications and Updates (CMS-6047-P). This notice indicates that the Centers for Medicare and Medicaid Services (CMS) plans on issuing proposed rules regarding options to address future medicals in relation to liability, workers’ compensation and no-fault cases.

12/20/2018 - 3 min read

MSPRP update: CMS announces a new self-reporting option and updates to the multi-factor authentication process

The Centers for Medicare and Medicaid Services (CMS) hosted a webinar focusing on enhancements to its Medicare Secondary Payer Recovery Portal (MSPRP) on December 18, 2018.

10/24/2018 - 7 min read

CMS updates its Medicare prescription drug benefit manual – New changes encourage Part D collection and recovery

The Centers for Medicare and Medicaid Services (CMS) has amended its Medicare Prescription Drug Benefit Manual (Part D Manual) to add, in part, stronger language regarding Medicare Part D sponsors’ secondary payer rights and recovery.

8/17/2018 - 1 min read

CMS hosts Medicare Secondary Payer Recovery Portal (MSPRP) Webinar

On August 16, 2018, the Centers for Medicare and Medicaid Services (CMS) hosted a webinar focusing on its Medicare Secondary Payer Recovery Portal (MSPRP).

8/14/2018 - 6 min read

Drug formularies continue to expand in workers’ comp systems

Balancing rising medical and pharmaceutical costs with appropriate and timely treatment for injured workers has been an ongoing struggle for workers’ compensation professionals. But recent trends indicate a positive change for the industry.

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7/12/2018 - 2 min read

Minor changes in newly released Medicare Secondary Payer Recovery Portal User Guide

The Centers for Medicare and Medicaid Services (CMS) has released an updated version of its Medicare Secondary Payer Recovery Portal (MSPRP) User Guide (Version 4.2). The changes are minor and primarily aimed at streamlining the communication process when requesting conditional payment information.

6/20/2018 - 4 min read

Law firm reaches settlement with U.S. Department of Justice to reimburse Medicare conditional payments and start internal MSP compliance program

The United States Department of Justice (DOJ) for the Eastern District of Pennsylvania has issued a news release reporting that a Philadelphia personal injury law firm has agreed to pay the government $28,000.00 to resolve allegations that the firm failed to reimburse Medicare conditional payments, and agreed to start an internal compliance program to ensure timely repayment of conditional payments going forward.