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Breaking CMS Medicare Updates

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January 22, 2021

CMS releases new NGHP Section 111 User Guide (Version 6.2, January 11, 2021)

CMS has released an updated Section 111 NGHP User Guide (Version 6.2, January 11, 2021) regarding non-group health plans (liability, no-fault, and workers’ compensation).

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January 11, 2021

The PAID Act is now law

On December 11th, President Trump signed into law the Provide Accurate Information Directly (PAID) Act as part of H.R 8900.

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December 16, 2020

LMSA update: CMS’s “future medicals” proposals now scheduled for release in March 2021 | New LMSA case decision highlights continuing claims challenges

LMSA update: OIRA has issued an updated noticing indicating CMS’s “future medical” proposals are delayed again and projected for release in March 2021.

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December 14, 2020

The PAID Act is now law

It requires CMS to expand its Section 111 Query Process to identify whether a claimant is currently entitled to.

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December 11, 2020

CMS holds NGHP beneficiary recovery process webinar

On 12/9, CMS held a non-group health plan beneficiary recovery process webinar aimed at attorneys who represent beneficiaries and other beneficiary representatives.

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December 9, 2020

PAID Act passes House, moves to the Senate

The House of Representatives passed the PAID Act as a stand-alone bill and as part of the BENES Act of 2019. Both bills now move to the Senate for further consideration.

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November 30, 2020

CMS retains $750 low dollar threshold for 2021

CMS has announced it is retaining its current $750 low dollar threshold for 2021.

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November 13, 2020

CMS releases new NGHP Section 111 User Guide (Version 6.1) and Technical Alert

CMS’ recently released NGHP Section 111 User Guide and Technical alert outline the eventually elimination of the ‘SP31’ error notices and updates to the “soft error”…

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November 10, 2020

CMS NGHP Beneficiary Recovery Process webinar December 9th

CMS has released a notice announcing that it will be holding a Non-Group Health Plan (NGHP) Beneficiary Recovery Process webinar on December 9, 2020, at 1:00 p.m. ET.

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October 8, 2020

CMS releases updated Medicare Secondary Payer Recovery Portal user guide

On 10/5/20, CMS released an updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide. The changes update the claims listing interface to provide additional…

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October 6, 2020

CMS releases new NGHP Section 111 User Guide (Version 6.0) and updated accepted/excluded ICD code listings

On 10/5/20, CMS released an updated Section 111 NGHP User Guide, V. 6.0. They also released updated versions of accepted and excluded ICD-9 and ICD-10 codes for 2021.

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October 6, 2020

CMS releases new WCMSA Reference Guide (Version 3.2)

On 10/5/20, CMS released its latest version of the WCMSA Reference Guide, Version 3.2. This guides replaces version 3.1, released on 5/11/20.

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September 28, 2020

CMS discusses conditional payment issues on NGPH applicable plans webinar

On 9/24, CMS and the CRC held a webinar on redetermination requests as part of the administrative appeals process for conditional payment disputes of non-group health…

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August 25, 2020

U.S. Department of Justice and plaintiff law firm reached a settlement to resolve a Medicare conditional payment claim

The DOJ’s Attorney’s Office for the Middle District of Pennsylvania has settled a Medicare conditional payment claim with the plaintiff law firm.

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August 20, 2020

What’s up in D.C.? Medicare Secondary Payer reform efforts – status update

With the current Congressional session ending on 1/3/21, attention is on two pending Medicare Secondary Payer reform efforts: The PAID Act & the COMP Act.

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