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