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Breaking CMS Medicare Updates

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August 14, 2020

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.

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August 11, 2020

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…

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August 7, 2020

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”…

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July 14, 2020

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…

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July 2, 2020

Eleventh Circuit rules that Florida Medicaid may seek recovery of its past payments from those portions of the settlement agreement representing past and future medical care

In a new Florida Medicaid decision, the U.S. Circuit Court of Appeals for the Eleventh Circuit, in Gallardo v. Dudek, 2020 ruled Florida Medicaid may seek recovery of…

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July 1, 2020

CMS releases new NGHP Section 111 User Guide (Version 5.9)

CMS has released an updated Section 111 NGHP User Guide (Version 5.9, June 29, 2020) regarding non-group health plans (liability, no-fault and workers’ compensation).

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July 1, 2020

CMS’s expected release of its “future medicals” proposals now scheduled for August 2020

An updated notice from the Office of Information and Regulatory Affairs indicates CMS’s long-anticipated release of its “future medicals” notice of proposed rulemaking is…

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June 16, 2020

Key changes to Michigan PIP start July 1, 2020 – Medicare Secondary Payer compliance impact

While individuals will still be able to elect unlimited PIP coverage, for applicable policies issued or renewed after 7/1/20, PIP plans with different coverage limits may…

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June 12, 2020

CMS releases Section 111 alert regarding the reporting of no-fault insurance and med-pay policy limits on claim input files

Limits on NGHP claim input files in situations where separate Med-Pay and PIP coverages being paid out under a single policy for the same injured party and incident.

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June 3, 2020

CMS to enhance its MSPRP to allow authorized users to view and print conditional payment correspondence

Starting July 13, 2020, authorized MSPRP users will be allowed to view and print CMS conditional payment correspondence.

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May 15, 2020

CMS releases new WCMSA reference guide (Version 3.1)

The Centers for Medicare and Medicaid Services (CMS) has just released its latest version of the WCMSA reference guide version 3.1 (May 11, 2020).

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May 11, 2020

Court dismisses law firm’s attempt to interplead HHS to resolve Medicare’s conditional payment claim

The United States District Court for the Western District of Missouri in Fowler Pickert LLC v. Glasgow, et. al., 2020 WL 1955266 (W.D. Missouri, April 23, 2020) had to…

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April 21, 2020

CMS’s Section 111 civil money penalties comment period closes

With the comment period closed, the focus now turns to when CMS will issue its Final Rule, which will comprise of the agency’s official CMP regulations. 

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March 6, 2020

CMS releases town hall question/answer document

The Centers for Medicare and Medicaid Services (CMS) has released a question/answer document in follow up to its January 14, 2010 town hall call.

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February 18, 2020

CMS’s Section 111 penalty proposals are here

CMS has released its long-awaited Section 111 civil money penalty proposals for non-group health plans, as well as group health plans.

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