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Breaking CMS Medicare Updates

Waiting For Cms Teaser
January 26, 2023

Waiting for CMS’s Section 111 penalties “final rule” – status, updates, and what’s next

Presently, the industry is waiting for CMS to release its Section 111 CMPs “final rule” to the public.

Cms Releases Teaser
January 17, 2023

CMS releases updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide (Version 5.6) – Updates to Open Debt Report, Compromise Requests, and Go Paperless notifications

The Centers for Medicare and Medicaid Services (CMS) has released an updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide Version 5.6 (January 9, 2023).

User Guide Teaser
January 12, 2023

CMS releases Section 111 NGHP User Guide (Version 7.0, January 9, 2023) – CMS announces several new updates to kick off 2023

The (CMS) has released an updated Section 111 NGHP User Guide (Version 7.0, January 9, 2023) regarding Section 111 reporting related to non-group health plans.

Future Liability Events
January 9, 2023

CMS releases request for proposal for the Workers’ Compensation Review Contractor (WCRC) contract

On January 4, 2023, the Centers for Medicare and Medicaid Services (CMS) issued an RFP for its Workers’ Compensation Review Contractor (WCRC) contract.

Medicare Teaser
December 22, 2022

Is the other “M” on your radar? 5 things to know about Medicaid and how we can help!

It is no secret that Medicare secondary payer compliance issues often dominate the claims landscape and discussion.

Cms Low Dollar Threshold 2023
December 15, 2022

CMS retains its $750 “Low Dollar” threshold for 2023

The Centers for Medicare and Medicaid Services (CMS) has released its 2023 low dollar reporting and recovery threshold.

Big Tobacco Nuclear Verdicts
December 9, 2022

The PAID Act one year after implementation – How is it going? What are we seeing?

On 12/11/21, the (PAID Act) went live following a year-long implementation roll-out by the Centers for Medicare and Medicaid Services (CMS).

Cms Medicare Teaser
November 16, 2022

CMS releases updated Workers’ Compensation Medicare Set-Aside Reference Guide (Version 3.8) – changes impact CMS’s WCMSA re-review process

The Centers for Medicare and Medicaid Services (CMS) has released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.8)

Nghp Section 111 Teaser
November 14, 2022

CMS to hold NGHP Section 111 Webinar on December 6th at 1:00 p.m. ET

The Centers for Medicare and Medicaid Services (CMS) has announced that it will be holding a non-group health plan (NGHP) Section 111 webinar.

Crc Recoveries Teaser
November 3, 2022

CMS releases data and statistics regarding CRC recoveries and WCMSAs

The Centers for Medicare and Medicaid Services (CMS) has released two new reports providing data regarding CRC recoveries and WCMSAs.

Circuit Court Teaser
October 31, 2022

U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages” – ruling affirms the district court’s award of double damages against insurer

U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages”

Marc Important Policy Update
October 14, 2022

CMS’s future medicals proposals have been withdrawn

In an important new development, an updated Office of Information and Regulatory Affairs (OIRA) notice reflects that CMS has withdrawn its “future medicals” proposals.

Cms Releases
October 4, 2022

CMS releases Section 111 NGHP User Guide (Version 6.9) – updates relate to Section 111 excluded/valid diagnosis codes for 2023, SP31 error, and other items

CMS releases Section 111 NGHP User Guide (Version 6.9) – updates relate to Section 111 excluded/valid diagnosis codes for 2023, SP31 error, and other items

Blog Teaser1 1
August 18, 2022

The U.S. Eleventh Circuit Court of Appeals applies a four-year statute of limitations to an MSP private cause of action claim – dismisses action as untimely

In an important new MSP decision, the U.S. Circuit Court of Appeals for the Eleventh Circuit in MSPA Claims 1, LLC v. Tower Hill Prime Insurance Co.

Blog Teaser15
June 1, 2022

Are indemnified EBMSAs still an effective tool after CMS released Section 4.3?

When the CMS released version 3.5 of the WCMSA reference guide on January 11, 2022, it redefined the potential risk and settlement considerations.

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