Breaking CMS Medicare Updates
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…
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…
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).
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…
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…
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.
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.
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).
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…
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.
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.
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.