Breaking CMS Medicare Updates
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.
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.
CMS retains $750 low dollar threshold for 2021
CMS has announced it is retaining its current $750 low dollar threshold for 2021.
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”…
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.
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…
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.
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.
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…
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.
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.
CMS holds Section 111 NGHP update webinar
On 8/13, CMS held a webinar on Section 111 non-group health plan reporting. The webinar covered NGHP Section 111 reporting best practices and MSPRP enhancements.
OIRA releases updated information Section 111 CMPs
OIRA released an updated notice on the status of CMS’s Section 111 civil money penalties proposals. CMS released the proposals in February 2020 and opened a public…
Connecticut court rules Medicare Advantage Plan entitled to double damages
The U.S. District Court for Connecticut in Aetna v. Guerrera, 2020 ruled, in part, the alleged self-insured supermarket was a primary plan and liable for “double damages”…
CMS releases updated Medicare Secondary Payer Recovery Portal (MSPRP) user guide (Version 4.9)
CMS has released an updated Medicare Secondary Payer Recovery Portal User Guide (Version 4.9, July 13, 2020). CMS has made multiple updates to the MSPRP, which the agency…