On 9/24, CMS and the CRC held a webinar on redetermination requests as part of the administrative appeals process for conditional payment disputes of non-group health…
On 8/13, CMS held a webinar on Section 111 non-group health plan reporting. The webinar covered NGHP Section 111 reporting best practices and MSPRP enhancements.
OIRA released an updated notice on the status of CMS’s Section 111 civil money penalties proposals. CMS released the proposals in February 2020 and opened a public…
CMS has released an updated Section 111 NGHP User Guide (Version 5.9, June 29, 2020) regarding non-group health plans (liability, no-fault and workers’ compensation).
While individuals will still be able to elect unlimited PIP coverage, for applicable policies issued or renewed after 7/1/20, PIP plans with different coverage limits may…
Limits on NGHP claim input files in situations where separate Med-Pay and PIP coverages being paid out under a single policy for the same injured party and incident.
The U.S. District Court in Ruiz v. Rhode Island was called upon to address whether a personal injury settlement should be enforced even though the defendant was unable to…
With the comment period closed, the focus now turns to when CMS will issue its Final Rule, which will comprise of the agency’s official CMP regulations.
The CDC issued a bulletin advising it is implementing the new ICD-10 U07.1 for “COVID-19, virus identified” in an off-cycle update effective 4/1/20, to code the COVID-19…
In a time of social distancing and uncertainty, many are left wondering how our current working and social paradigm will impact workers’ compensation claims handling –…
CMS has released its long-awaited Section 111 civil money penalty proposals for non-group health plans, as well as group health plans.
OIRA announced CMS’s expected release of its Notice of Proposed Rulemaking proposals for Section 111 civil money penalties has been pushed to December 2019.
CMS has issued an updated Section 111 Alert pertaining to non-group health claims (NGHP) regarding the Medicare Beneficiary Identifier (MBI) reporting.
On 10/7/19, CMS released an updated Section 111 User Guide (Version 5.7) regarding non-group health plans (liability, no-fault and workers’ compensation).
In a significant new case out of California, the United States Circuit Court of Appeals (Ninth Circuit)[1] in California Insurance Guarantee Association (CIGA) v. Azar,…