On 12/9, CMS held a non-group health plan beneficiary recovery process webinar aimed at attorneys who represent beneficiaries and other beneficiary representatives.
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 has announced it is retaining its current $750 low dollar threshold for 2021.
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 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.
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…
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.
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.
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…
The DOJ’s Attorney’s Office for the Middle District of Pennsylvania has settled a Medicare conditional payment claim with the plaintiff law firm.
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.
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 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…
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 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…