Section 111 Reporting

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.

10/5/2018 - 2 min read

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 (NGHP) Section 111 User Guide.

5/22/2018 - 5 min read

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.

2/28/2018 - 7 min read

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.

1/19/2018 - 4 min read

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 from CGI Federal to Performant Financial Corporation.

12/21/2017 - 3 min read

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).

10/6/2017 - 2 min read

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.

9/26/2017 - 6 min read

Countdown to “full and final” settlements: Arizona S.B. 1332

The recent passage of Arizona Senate Bill (S.B.) 1332 provides Arizona claims payers with unprecedented opportunity to close out their workers' comp claims.

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7/11/2017 - 2 min read

A solid second bite: CMS re-review now allows new medical documentation

Yesterday, CMS released a new Workers’ Compensation Medicare Set-Aside Portal User Guide that now allows for re-reviews of WCMSA decisions.

7/7/2017 - 2 min read

Medicare Section 111 process change eases one compliance burden

RREs will no longer automatically be moved into “discontinued” status if they fail to provide Medicare the requested annual recertification information.

5/22/2017 - 4 min read

New realities: The Section 111 connection to conditional payments and claim outcomes

Section 111 reporting used to be viewed as an abstract technical Medicare compliance obligation & IT's responsibility because of the data transmission.

5/17/2017 - 5 min read

Risky business: Five essential tips for Section 111 reporting

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.

12/16/2016 - 2 min read

CMS releases updated reporting and recovery thresholds with news on TPOCs

The Centers for Medicare and Medicaid Services (CMS) has released its latest alert regarding its low-dollar reporting and recovery thresholds pertaining to liability (including self-insurance), workers' compensation, and no-fault settlements, judgments, awards, or other payments (settlements).

9/19/2016 - 4 min read

The compliance gap: How you see your compliance vs. how Medicare sees it

There are two main categories of Medicare compliance: (1) reporting and (2) recovery. Although the law and regulations clearly state what must be done in each category and who must comply, the actual process of compliance can be quite challenging.

8/19/2016 - 4 min read

Preparing for a fundamental compliance shift in liability claims

Liability claims are particularly at risk, as these emerging compliance issues impose new burdens on the management and settlement of claims.