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Compliance

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5/1/2020 - 19 min read

Court finds state of Rhode Island compliant with Section 111 despite its inability to obtain social security information to determine Medicare status and enforces settlement

The U.S. District Court in Ruiz v. Rhode Island was called upon to address whether a personal injury settlement should be enforced even though the defendant was unable to obtain the plaintiff’s social security number, or the last five digits of his SSN, to determine his Medicare status through CMS’s Section 111 Query Process.

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4/28/2020 - 2 min read

New tools translate to higher lender/insurer efficiency

Verisk is rolling out CV-VaaS (Verification as a Service) to connect key information between lenders and insurers via a new contributory database.

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4/22/2020 - 5 min read

To build or not to build: Getting portal claims solutions right in the wake of whiplash reform

Crucial questions remain over whether insurers have the in-house capacity and expertise to develop truly fit-for-purpose solutions, or if they should opt for an industry partner to deploy an off-the shelf solution.

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3/30/2020 - 9 min read

Settling claims in unsettling times

In a time of social distancing and uncertainty, many are left wondering how our current working and social paradigm will impact workers’ compensation claims handling – especially being able to close claims.

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3/30/2020 - 4 min read

Social Security Administration suspends processing of third-party requests to determine SSDI status

As of 3/17/20, all the Social Security Administration field offices have been closed to the public in response to the growing COVID-19 pandemic according to its website. Despite the closures, the SSA remains functional.

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3/27/2020 - 2 min read

Why report commercial vehicle coverage in optional states?

Commercial auto insurance has varying state regulatory mandates for reporting auto liability insurance. What should insurers do where reporting is optional?

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3/10/2020 - 5 min read

Stronger together: ISO and insurer collaboration still makes sense today

Learn how ISO Core Line Services, the insurance policy program of forms, rules and loss costs, can make your business stronger.

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2/27/2020 - 14 min read

The Eleventh Circuit rules that the MSP’s three-year “claims-filing” statute is not a prerequisite for filing a private cause of action recovery claim

In reversing a lower court decision, the U.S. Circuit Court of Appeals (Eleventh Circuit) in MSPA Claims 1, LLC v. Kingsway Amigo Insurance ruled compliance with the Medicare Secondary Payer’s “claims-filing” statute was not a prerequisite for filing a private cause of action recovery claim.

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2/18/2020 - 12 min read

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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2/12/2020 - 21 min read

California spotlight: Medicare Advantage recovery rights

The issue of Medicare Advantage Plans recovery rights has catapulted to the compliance forefront over the past few years following a series of court rulings finding that MAPs can sue claims payers for “double damages” under the Medicare Secondary Payer private cause of action provision.

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1/16/2020 - 4 min read

Data management and reporting services: Vital for start-ups and acquisitions

Data management and statistical reporting are serious business - insurers must constantly prepare, manage, and report accurate data, daunting to larger insurers and even more difficult for start-ups or acquisitions.

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12/12/2019 - 2 min read

Spend less time on regulatory updates, more time pursuing profitable growth

Insurers that process regulatory changes manually could dramatically reduce costs by using ISO Electronic Rating Content.

Proposal

11/21/2019 - 3 min read

Release of CMS’s Section 111 penalty proposals delayed again – pushed back to December

OIRA announced CMS’s expected release of its Notice of Proposed Rulemaking proposals for Section 111 civil money penalties has been pushed to December 2019.

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11/20/2019 - 3 min read

Automating regulatory updates can mitigate a key risk for many insurers

ISO ERC allows insurers to ingest ISO rating content electronically through XML, simplifying maintenance and update while giving flexibility to use own systems.

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9/13/2019 - 2 min read

Pursuing peace and quiet in third-party notifications

Lienholder and additional interest notifications, returned mail, producer notifications, and escrow invoices can move faster if insurers have the right tools.

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