VISUALIZE | INSIGHTS THAT POWER INNOVATION

Breaking CMS Medicare Updates

Mika Baumeister Wpnoqo2plfa Unsplash 2
October 23, 2019

CMS releases new NGHP Section 111 user guide (Version 5.7)

On 10/7/19, CMS released an updated Section 111 User Guide (Version 5.7) regarding non-group health plans (liability, no-fault and workers’ compensation).

Jeshoots Com Ltnvqhdkkmw Unsplash 2
October 18, 2019

CMS releases WCMSA Self-Administration Toolkit 1.3

CMS has released the latest edition of its Self-Administration Toolkit for Workers’ Compensation Medicare Set-Aside Arrangements (Version 1.3; October 10, 2019).

John Schnobrich Flpc9 Vocj4 Unsplash
October 10, 2019

CMS releases WCMSA Portal User Guide Version 5.9

On 10/7/19, CMS released the latest edition of its Workers’ Compensation Medicare Set-Aside Portal User Guide (WCMSAP) (Version 5.9).

J Kelly Brito Peujyoylfe4 Unsplash 2
October 7, 2019

Conditional payment updates | Open Debt Reports are back; Pre-PCN worksheets are on hold; and CRC will continue to review all CPL disputes

There has been a flurry of recent activity from the Centers for Medicare and Medicaid Services (CMS) and the Commercial Repayment Center (CRC) regarding processing of…

Abby Anaday Z3fxpuxa15k Unsplash
September 17, 2019

CMS will use the 2016 CDC Life Table for WCMSAs starting 10/12/19

On 9/12/19, CMS announced beginning 10/12/19, it will use the new 2016 CDC Life Table to calculate adjusted life expectancies in WCMSAs.

Lucas Vasques 9vnacvx2748 Unsplash 1
August 12, 2019

Release of proposed “future medicals” rules will be delayed

CMS’s release of proposed rules to address “future medicals” in relation to non-group health plan settlements will be delayed from Sept. 2019 to Oct. 2019.

Jubal Kenneth Bernal Uvdhvgaeem4 Unsplash
July 15, 2019

CMS releases new NGHP Section 111 user guide (Version 5.6)

On 7/1/19, CMS released an updated Section 111 User Guide (Version 5.6) regarding non-group health plans (liability, no-fault and workers’ compensation).

Mikhail Pavstyuk Eky2otrpxdw Unsplash
July 8, 2019

Medicaid expansion makes recovery efforts more urgent

Within broad federal requirements, states and territories have significant flexibility in program design and administration, resulting in 56 unique Medicaid programs. 

Campaign Creators Pypeceajezy Unsplash 1
May 31, 2019

To avoid CMS penalty exposure time is of the essence

The timely reporting of ORM and TPOC data to CMS is of key importance to insurers, especially now enforcement of noncompliance penalties is on the horizon.

Crew 4hg8lh9hoxc Unsplash
May 17, 2019

With civil money penalties looming, it’s time to fine-tune CMS reporting

Steering clear of CMS penalties is possible by implementing a meticulous query process and being mindful of the regulations surrounding ongoing medicals and total payment…

Helloquence 5fnmwej4taa Unsplash
March 14, 2019

CMS holds webinar to address plans to add electronic payment functionality to its Medicare Secondary Payer Recovery Portal

On 3/13/19, CMS held a webinar to discuss its plans to add electronic payment functionality to its Medicare Secondary Payer Recovery Portal.

J Kelly Brito Peujyoylfe4 Unsplash 2
February 27, 2019

Electronic payment functionality to be added to the Medicare Secondary Payer Recovery Portal – CMS to hold webinar on March 13, 2019

CMS announced effective April 1, 2019, electronic payment functionality will be added to the Medicare Secondary Payer Recovery Portal.

Mika Baumeister Wpnoqo2plfa Unsplash 1
February 25, 2019

CMS to mask health insurance claim number and social security number on contractor correspondence starting April 2019

Starting 4/1/19, CMS’s Coordination of Benefits and Recovery Program program will mask the social security number (SSN) and SSN-portion of the health insurance claim…

Wcmsaguide2
January 7, 2019

CMS releases new WCMSA Reference Guide (Version 2.9)

On 1/4/19, CMS released their latest version of the WCMSA reference guide Version 2.9.

Olia Gozha J4kk8b9fgj8 Unsplash
January 4, 2019

CMS releases new NGHP Section 111 user guide

CMS has updated its Non-Group Health Plan Section 111 User Guide. The new guide is styled as Version 5.5 and is dated January 7, 2019.