Breaking CMS Medicare Updates
CMS to finalize new expedited conditional payment process
The Centers for Medicare and Medicaid Services (CMS) has announced plans to modify its Medicare Secondary Payer Recovery Portal (MSPRP) to include final conditional…
Preparing for ICD-10: are you ready?
For the past year, it’s been difficult to overlook the numerous reminders from the Centers for Medicare and Medicaid Services (CMS) regarding the upcoming transition from…
CMS alert: upcoming reduction in time frame for referrals of delinquent debts to Treasury
On August 5, 2015, the Centers for Medicare and Medicaid Services (CMS) released an alert indicating that the time frame for referrals of delinquent debts to the U.S.…
FDA approves generic Abilify: Potential impact on Medicare set-asides
On April 25, 2015, the FDA issued approval for multiple manufacturers to market generic aripiprazole (Abilify).
The MIR code: Demystifying Section 111
At its heart, Section 111 of the MMSEA (Medicare reporting) doesn’t need to be overly complicated. When separated into its smaller parts, Section 111 reporting is fairly…
Primary payer appeals: CMS final rule
On February 27, 2015, the Centers for Medicare and Medicaid Services (CMS) released the final rule allowing primary payers to appeal conditional payment demands.
Medicare set-aside update: Generic Nexium and its impact on MSAs
On January 26, 2015, the FDA approved esomeprazole, the generic form of Nexium. Claims payers and the Medicare Set-Aside (MSA) industry take notice any time a widely…
ICD-10 update
One of the most important developments in Medicare Secondary Payer compliance for 2015 will be the transition from ICD-9 codes to ICD-10 codes on October 1, 2015. On that…
Section 111 level set changes, updates and watch list items for 2015
It has been roughly seven years since the Section 111 reporting requirements were enacted into law. During this time, the industry has witnessed and worked through…
CMS releases new Section 111 alert regarding SSNs
CMS has released a new NGHP Section 111 alert providing additional information regarding its plans to allow RREs to submit partial social security numbers (SSNs) for…
CMS alert: Introducing recovery agents
The Centers for Medicare and Medicaid Services (CMS) has released a technical alert outlining the role of a designated recovery agent in Medicare Secondary Payer (MSP)…
CMS withdraws its 'future medicals' notice of proposed rulemaking
Last week the Centers for Medicare and Medicaid Services (CMS) withdrew its Notice of Proposed Rulemaking (NPRM) for “future medicals” proposals for liability and…
Preparing for the ICD-10 Transition
CMS released an alert in May 2014 announcing that the ICD-10 diagnosis codes reporting for Section 111 is postponed until October 1, 2015.
Major Medicare reforms become law — Are you ready?
In a major development on the Medicare front, President Obama has signed the Strengthening Medicare and Repaying Taxpayers (SMART) Act into law.
CMS approves backlog of older WC-MSA proposals
In December 2012, the Centers for Medicare and Medicaid Services (CMS) approved a substantial backlog of older workers' compensation Medicare Set Aside (WC-MSA)…