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Breaking CMS Medicare Updates

Cms Expands Tpoc Teaser
November 16, 2023

CMS discusses plans to capture WCMSA data points as part of TPOC reporting during recent Section 111 webinar

CMS held a webinar to discuss its plans to require Section 111 (RREs) to report data points related to WCMSAs

Cms New Update Teaser
October 11, 2023

CMS’s Section 111 penalties “final rule” released – breaking down CMS’s penalty provisions and how they impact Section 111 reporting

In an important development, CMS has released its Section 111 penalties “Final Rule” --- CMS penalties will go live in 60 days.

Audience Clapping
October 10, 2023

An award-winning effort breaks new ground in medical record review

Verisk leaders earn Technology Innovation honoree status in the 2023 PC360 Insurance Luminary program for their work on Discovery Navigator

Important Cms Alert Teaser
September 28, 2023

OIRA issues new notice regarding Section 111 civil money penalties - notice addresses the proposed rule’s economic impact designation

As many will recall, earlier this year the (CMS) extended the timeline to release its Section 111 civil money penalties (CMP) “Final Rule” until February 18, 2024.

Cms October Teaser
September 18, 2023

CMS announces increase to Maximum Settlement Amount for Fixed Percentage Demand Calculation Option starting October 2, 2023

CMS has announced that effective October 2, 2023, the maximum total settlement amount for the Fixed Percentage Demand Calculation Option.

Court Of Justice Ma
August 10, 2023

United States District Court for Massachusetts rules that a MAP assignee has standing

New Medicare Advantage recovery case, the US District Court for MA in MSP Recovery Claims Series 44, LLC v. Bunker Hill Insurance Company, 2023 WL 4744739 two questions

Closing Tplf Teaser
August 9, 2023

Closing TPLF “data gaps” – recently discussed options and considerations

Whether parties using TPLF should be required to disclose the TPLF agreement to the opposing party as part of claims litigation continues to be a hotly debated topic.

Cms Releases August Teaser
August 8, 2023

CMS releases NGHP User Guide (Version 7.3) – updates include changes to the ORM trigger and CMS’s Unsolicited Response File process

The (CMS) has released an updated Section 111 NGHP User Guide (Version 7.3, August 7, 2023) regarding Section 111 reporting related to non-group health plans

Esg Claims
July 19, 2023

ESG claims – TPLF’s next frontier?

This is a continuing study of emerging Third-Party Litigation Funding (TPLF) issues.

Mid Year Legal Review Teaser
June 28, 2023

Mid-Year “Round-Up” 2023 – keeping track of Medicare and other claims updates (ICYMI)

We are at the mid-point for 2023! It has been a busy year in so many claims areas. Time to regroup on the key claims updates over the past months – ICYMI style!

Cms Section Teaser
June 27, 2023

CMS’s Section 111 NGHP Unsolicited Response File “opt-in” process – Nutshell Summary Resource

CMS’s Section 111 NGHP Unsolicited Response File “opt-in” process – Nutshell Summary Resource. The following “Nutshell Summary” is a general summary of this process.

Understanding Cms Teaser
June 27, 2023

Understanding CMS’s Section 111 NGHP Unsolicited Response File “opt-in” process (starts July 2023) – Q&A resource (updated)

Understanding CMS’s Section 111 NGHP Unsolicited Response File “opt-in” process (starts July 2023) – Q&A resource (updated)

Lousiana Cms Teaser
June 23, 2023

Governor Edwards vetoes Louisiana’s proposed Third-Party Litigation Funding (TPLF) disclosure bill

S.B. 196, as outlined more fully below, called for the disclosure of (TPLF), referred to as “litigation financing agreements” in the bill, in civil actions.

Indiana Third Party
June 9, 2023

Indiana enacts statutory provision regarding third-party litigation funding (TPLF) disclosure

On April 20, 2023, Indiana Governor Eric Holcomb (R) signed into law Indiana House Bill 1124 which adds a third-party litigation funding (TPLF)

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