Section 111 Reporting
Conditional payment updates | Open Debt Reports are back; Pre-PCN worksheets are on hold; and CRC will continue to review all CPL disputes
There has been a flurry of recent activity from the Centers for Medicare and Medicaid Services (CMS) and the Commercial Repayment Center (CRC) regarding processing of…
CMS releases new NGHP Section 111 user guide (Version 5.6)
On 7/1/19, CMS released an updated Section 111 User Guide (Version 5.6) regarding non-group health plans (liability, no-fault and workers’ compensation).
Think about your thresholds: Preventing errors to avoid CMS penalties
One way responsible reporting entities can attempt to achieve full CMS compliance and avoid potential penalties is to closely consider file thresholds.
Big reforms are coming to Michigan PIP - How the changes will impact Medicare Secondary Payer compliance
On 5/30/19, Governor Gretchen Whitmer signed Michigan Senate Bill 1, which makes significant changes to Michigan’s personal injury protection (PIP) system.
Avoiding penalty problems by ensuring data accuracy
With CMS (Centers for Medicare and Medicaid Services) penalties on the horizon, we’ve been exploring how RREs (Responsible Reporting Entities) can be proactive in…
To avoid CMS penalty exposure time is of the essence
The timely reporting of ORM and TPOC data to CMS is of key importance to insurers, especially now enforcement of noncompliance penalties is on the horizon.
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…
CMS releases new NGHP Section 111 user guide
CMS has updated its Non-Group Health Plan Section 111 User Guide. The new guide is styled as Version 5.5 and is dated January 7, 2019.
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,…
CMS releases new WCMSA Reference Guide and NGHP Section 111 User Guide
The Centers for Medicare and Medicaid Services (CMS) has updated both its Workers' Compensation Medicare Set-Aside (WCMSA) Reference Guide and its Non-Group Health Plan…
Arizona tweaks its "full & final" workers' comp settlement law - New law provides opportunities to settle workers' comp claims
Arizona Senate Bill 1100 provides unprecedented opportunities to settle workers' compensation claims in the state.
Medicare watch list: Staying ahead of the Medicare Secondary Payer compliance curve
As another new year settles in, we know at least one thing is certain: MSP compliance will continue to present formidable challenges for claims payers.
CMS holds town hall call on CRC transition - CMS provides important updates on ORM recovery transition
On January 18, 2018, CMS held its Commercial Repayment Center Non-Group Health Plan (NGHP) Town Hall presentation to address the upcoming transition of CRC operations…
CMS Releases New Section 111 NGHP User Guide (Version 5.3)
The Centers for Medicare and Medicaid Services (CMS) has released an updated Section 111 non-group health plan (NGHP) User Guide (Version 5.3, December 15, 2017).
Performant awarded CMS Commercial Repayment Center contract
The Centers for Medicare and Medicaid Services (CMS) awarded Performant Financial Corporation (Performant) the Commercial Repayment Center (CRC) contract.