Claims

A prescription pad and pill bottle in front of a one hundred dollar bill.

4/10/2024 - 6 min read

NCCI Cuts Eligibility for Medical and Indemnity Data Call Reporting

NCCI reduced the participation eligibility threshold for reporting both the Medical Data Call (“MDC”) and Indemnity Data Call (“IDC”).

4/9/2024 - 1 min read

CMS to Hold Second TPOC/WCMSA Webinar on April 16, 2024 at 2:00 p.m. ET

CMS will be holding its second TPOC/WCMSA webinar on April 16th to discuss its plans to use Section 111 TPOC reporting to collect WCMSA data as part NGHP Section 111 reporting.

4/3/2024 - 12 min read

CMS Releases S.111 NGHP User Guide Version 7.5

CMS has released an updated Section 111 NGHP User Guide (Version 7.5, April 1, 2024) regarding S.111 reporting related to NGHPs.

2/26/2024 - 7 min read

CMS Releases New Information About TPOC/WCMSA Data Collection Process

A February Alert provided more information on CMS’s plans to require RREs to report WCMSA data as part of its TPOC reporting trigger.

1/31/2024 - 5 min read

CMS Releases Updated MSPRP User Guide (Version 6.0)

CMS released an updated MSPRP user guide (Version 6.0), which includes several updates to MSPRP's functionality.

1/30/2024 - 21 min read

CMS Releases Section 111 NGHP User Guide (Version 7.4)

CMS released an updated Section 111 NGHP User Guide (Version 7.4) regarding reporting related to non-group health plans (NGHPs).

1/23/2024 - 20 min read

CMS Discusses NGHP Section 111 Civil Money Penalties on its First CMPs Webinar

CMS’s Section 111 ‘penalties’ webinar discussed different CMPs changes, including, how CMPs will be calculated, the audit process, notice/appeal, and safe harbors.

1/18/2024 - 22 min read

New TPL Bills Introduced in the Florida Legislature

The new year is off to a fast start on the Third Party Litigation Funding (TPLF) front with two new TPLF bills introduced in Florida.

1/4/2024 - 1 min read

Login Details Now Available for CMS Section 111 Penalties Webinar

CMS just provided new information on how to attend its January 18, 2024 NGHP CMPs webinar. Read the article to learn how you can attend.

12/11/2023 - 1 min read

CMS Announces Updates to the Medicare Secondary Payer Recovery Portal

(CMS) released an alert announcing that in January 2024 a new enhancement will be made to the MSPRP portal

12/11/2023 - 17 min read

Insurers Request House Take Lead in Addressing TPLF Practices

25 insurers (and other companies) recently sent a letter to the U.S. House of Representatives regarding TPLF practices.

12/7/2023 - 11 min read

Breaking Down CMS’s Plans to Capture WCMSA Data

CMS has announced plans to require Section 111 RREs to report various data points related to WCMSA arrangements

12/6/2023 - 9 min read

FROI/SROI and WCIO 2023 Recap–Breaking Down Key Updates and Getting Ready for 2024

These new compliance updates and changes kept insurers busy and will have a significant impact for insurers going forward in the new year.

12/5/2023 - 1 min read

CMS to Hold NGHP Section 111 Penalties Webinar

CMS will be holding a Section 111 civil money penalties (CMP) webinar for (NGHPs) on January 18, 2024 at 1:00 p.m. ET.

11/29/2023 - 8 min read

CMS Corrects Minor “Technical Errors” in the Section 111 Penalties

In a new development, CMS has issued an update which corrects certain “technical errors” in the Section 111 final rule.