Section 111 Reporting
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
Mid-Year “Round-Up” 2023 – keeping track of Medicare and other claims updates (ICYMI)
We are at the mid-point for 2023! It has been a busy year in so many claims areas. Time to regroup on the key claims updates over the past months – ICYMI style!
CMS holds webinar to discuss the Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File “opt-in” feature (starts July 2023) and other Section 111 items
(CMS) held a webinar where the agency discussed its upcoming Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File “opt-in” feature (starts July 2023)
CMS releases Section 111 NGHP User Guide (Version 7.2, June 5, 2023) – new changes include: NGHP Unsolicited Response File, ORM reporting trigger, ORM termination, and HEW software
(CMS) has released an updated Section 111 NGHP User Guide regarding Section 111 reporting related to non-group health plans.
The United States District Court for Massachusetts dismisses a Medicare Advantage claim for “double damages” – rules that insurer’s Section 111 reporting does not establish standing to sue
The U.S. District Court for Massachusetts dismisses Medicare Advantage claim for “double damages”—rules insurer’s Section 111 reporting doesn't establish standing to sue.
CMS’s Query Process and non-binary/unspecified gender designations – current issues and considerations
Section 111 non-group health plan (RREs) involves the inability to submit non-binary or unspecified gender designations as part of the (CMS’s)
Second Circuit dismisses Medicare Advantage “double damages” lawsuit on standing grounds – rules the insurer’s Section 111 reporting did not establish liability
In an interesting new Medicare Advantage recovery decision, the United States Second Circuit Court of Appeals in MSP Recovery Claims.
Waiting for CMS’s Section 111 penalties “final rule” – status, updates, and what’s next
Presently, the industry is waiting for CMS to release its Section 111 CMPs “final rule” to the public.
CMS pushes back the timeline to release its Section 111 penalties “final rule” for one-year (until February 18, 2024)
In a major Section 111 development, (CMS) has extended the timeline to release its Section 111 civil money penalties (CMP) “final rule” until February 18, 2024.
CMS makes updates to Section 111 NGHP User Guide (Version 7.0) – updates relate to upcoming changes to the NGHP Unsolicited Response File
As reported in our recent article, in early January CMS released a new version of their Section 111 NGHP Section 111 User Guide (Version 7.0, January 9, 2023).
CMS releases updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide (Version 5.6) – Updates to Open Debt Report, Compromise Requests, and Go Paperless notifications
The Centers for Medicare and Medicaid Services (CMS) has released an updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide Version 5.6 (January 9, 2023).
CMS releases Section 111 NGHP User Guide (Version 7.0, January 9, 2023) – CMS announces several new updates to kick off 2023
The (CMS) has released an updated Section 111 NGHP User Guide (Version 7.0, January 9, 2023) regarding Section 111 reporting related to non-group health plans.
CMS retains its $750 “Low Dollar” threshold for 2023
The Centers for Medicare and Medicaid Services (CMS) has released its 2023 low dollar reporting and recovery threshold.
CMS releases Section 111 NGHP User Guide (Version 6.9) – updates relate to Section 111 excluded/valid diagnosis codes for 2023, SP31 error, and other items
CMS releases Section 111 NGHP User Guide (Version 6.9) – updates relate to Section 111 excluded/valid diagnosis codes for 2023, SP31 error, and other items
Claims commitment: Empowering insurers on the innovation journey
The insurance industry has experienced tremendous change in the past few years.