Claims
U.S. Supreme Court hears oral arguments on Medicaid reimbursement case – Court’s forthcoming decision will revisit Medicaid’s recovery rights
On January 10, 2022, the United States Supreme Court heard oral argument in the case Gallardo by and through Vassallo v. Marstiller (No. 20-1263).
Taking flight: Exploring anti-fraud technology with better pilots
Digital adoption and automation have rapidly accelerated the past two years, and fraud management needs to keep pace.
New Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5) takes aim at non-submit and EBMSAs
Centers for Medicare and Medicaid Services (CMS) has released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5, January 10, 2022).
CMS releases new Section 111 NGHP User Guide (Version 6.6)
CMS releases new Section 111 NGHP User Guide (Version 6.6) and an updated Section 111 NGHP 270/271 Companion Guide (Version 5.8)
CMS retains its $750 “Low Dollar” threshold for 2022
The Centers for Medicare and Medicaid Services (CMS) has released its 2022 low dollar reporting and recovery threshold via a new alert.
Enhancing Customer Experience and Innovating for the Future as Verisk
Insurance industry advances towards digital transformation of enterprise-wide processes and systems, the need for trusted partners in this journey has never been greater
LMSA update: CMS’s “future medicals” proposals now scheduled for release in February 2022
A Fall 2021 notice indicating that CMS’s long-anticipated release of its “future medicals” notice of proposed rulemaking (NPRM) is now scheduled for February 2022.
Uncovering digital media fraud with advanced forensics
Straight-through processing is considered the holy grail of digital claims—where insurers can intake, process, and pay claims automatically
The PAID Act is now live – a new era of MSP compliance starts
Lights, camera, action! The Provide Accurate Information Directly (PAID) Act became effective as of December 11, 2021 and is now live!
Economic shifts shape the unfolding journey for homeowners insurers
Supply-chain issues, labor shortages, and high demand for building resources are complicating factors as homeowners insurers head into 2022.
Analytics can help you navigate an ever-changing legal landscape
It is imperative for insurance companies to keep track of court decisions that may affect them in an ever-changing legal landscape.
Solving the puzzle of lienholder clauses
For insurers, validating correct lienholder information on loss payable and mortgagee clauses can be a long and cumbersome process.
CMS adjusts the maximum Section 111 reporting civil money penalties amount for inflation
CMS has released its “Adjustment of Civil Monetary Penalties for Inflation and the Annual Civil Monetary Penalties Inflation for 2021”.
2021 personal auto growth and profitability: Unprecedented in new ways
Personal auto insurers had a year without precedent in 2020, and 2021 may break more new ground, but in very different ways.
Federal rules committee recommends no immediate action for third-party funding disclosure rulemaking at recent meeting
Federal rules committee recommends no immediate action for TPF disclosure rulemaking at recent meeting