Breaking CMS Medicare Updates

11/14/2022 - 1 min read

CMS to hold NGHP Section 111 Webinar on December 6th at 1:00 p.m. ET

The Centers for Medicare and Medicaid Services (CMS) has announced that it will be holding a non-group health plan (NGHP) Section 111 webinar.

11/3/2022 - 10 min read

CMS releases data and statistics regarding CRC recoveries and WCMSAs

The Centers for Medicare and Medicaid Services (CMS) has released two new reports providing data regarding CRC recoveries and WCMSAs.

10/31/2022 - 22 min read

U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages” – ruling affirms the district court’s award of double damages against insurer

U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages”

10/14/2022 - 1 min read

CMS’s future medicals proposals have been withdrawn

In an important new development, an updated Office of Information and Regulatory Affairs (OIRA) notice reflects that CMS has withdrawn its “future medicals” proposals.

10/4/2022 - 7 min read

CMS releases Section 111 NGHP User Guide (Version 6.9) – updates relate to Section 111 excluded/valid diagnosis codes for 2023, SP31 error, and other items

8/18/2022 - 29 min read

The U.S. Eleventh Circuit Court of Appeals applies a four-year statute of limitations to an MSP private cause of action claim – dismisses action as untimely

In an important new MSP decision, the U.S. Circuit Court of Appeals for the Eleventh Circuit in MSPA Claims 1, LLC v. Tower Hill Prime Insurance Co.

5/31/2022 - 1 min read

Starting June 4, 2022, CMS Will Use the 2019 CDC Life Table for WCMSAs

4/14/2022 - 4 min read

CMS discusses the MSPRP’s “go paperless” function at recent webinar

CMS held a webinar to discuss the Medicare Secondary Payer Recovery Portal’s (MSPRP’s) “Go Paperless” function.

3/3/2022 - 11 min read

CMS on the move: Section 111 civil money penalties Final Rule and Future Medicals proposals are pending review for release

The OIRA website indicates that CMS’s long-awaited S111 CMP “final rule” and their “Future Medicals” proposals are completed and are now pending OIRA review for release.

2/18/2022 - 12 min read

CMS holds WCMSA webinar CMS discusses non-submit/EBMSAs, allocation pricing, denials, and other important WCMSA topics

On February 17, 2022 the Centers for Medicare and Medicaid Services (CMS) held a webinar session to address workers’ compensation Medicare set-aside (WCMSA) issues.

2/7/2022 - 2 min read

CMS to hold WCMSA webinar on February 17, 2022 – several key WCMSA topics are on CMS’s agenda

The Centers for Medicare and Medicaid Services (CMS) will discuss a variety of topics related to Workers’ Compensation Medicare Set-Asides (WCMSAs).

1/13/2022 - 5 min read

New Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5) takes aim at non-submit and EBMSAs

Centers for Medicare and Medicaid Services (CMS) has released an updated Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5, January 10, 2022).

1/12/2022 - 4 min read

CMS releases Section 111 NGHP User Guide (Version 6.7) – new updates provide a GoPaperless option for Medicare Secondary Payer Recovery Portal users

CMS has released an updated Section 111 NGHP User Guide (V 6.7, Jan 10, 2022) regarding non-group health plans. This updated guide replaces Version 6.6 (Dec. 13, 2021).

12/22/2021 - 17 min read

CMS releases new Section 111 NGHP User Guide (Version 6.6)

CMS releases new Section 111 NGHP User Guide (Version 6.6) and an updated Section 111 NGHP 270/271 Companion Guide (Version 5.8)

Breaking CMS Medicare Updates

CMS releases updated Workers’ Compensation Medicare Set-Aside Reference Guide (Version 3.8) – changes impact CMS’s WCMSA re-review process

CMS to hold NGHP Section 111 Webinar on December 6th at 1:00 p.m. ET

CMS releases data and statistics regarding CRC recoveries and WCMSAs

U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages” – ruling affirms the district court’s award of double damages against insurer

CMS’s future medicals proposals have been withdrawn

CMS releases Section 111 NGHP User Guide (Version 6.9) – updates relate to Section 111 excluded/valid diagnosis codes for 2023, SP31 error, and other items

The U.S. Eleventh Circuit Court of Appeals applies a four-year statute of limitations to an MSP private cause of action claim – dismisses action as untimely

Starting June 4, 2022, CMS Will Use the 2019 CDC Life Table for WCMSAs

CMS discusses the MSPRP’s “go paperless” function at recent webinar

CMS on the move: Section 111 civil money penalties Final Rule and Future Medicals proposals are pending review for release

CMS holds WCMSA webinar CMS discusses non-submit/EBMSAs, allocation pricing, denials, and other important WCMSA topics

CMS to hold WCMSA webinar on February 17, 2022 – several key WCMSA topics are on CMS’s agenda

New Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5) takes aim at non-submit and EBMSAs

CMS releases Section 111 NGHP User Guide (Version 6.7) – new updates provide a GoPaperless option for Medicare Secondary Payer Recovery Portal users

CMS releases new Section 111 NGHP User Guide (Version 6.6)