Mandatory Insurer Reporting
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CMS Updates NGHP User Guide & NGHP Applicable Plan Appeals Guide
by F. Fairchok The Centers for Medicare & Medicaid Services (CMS) published updates to both the Non-Group Health Plan (NGHP) Section 111 Reporting User Guide and the Non-Group Health Plan...
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What to Know About Section 111 Audits
by B. Smith Section 111 audits are an important cost-containment measure to prevent potential Civil Money Penalties (CMPs) and conditional payment exposure. However, the thought of an audit can be...
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CMS to Host Q&A Session on the Expansion of TPOC Reporting on April 25
Due to technical difficulties during their April 16 webinar on an upcoming change to Section 111 Workers’ Compensation Reporting, that did not allow attendees to ask questions, CMS will...
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CMS Hosts April Townhall to Review Section 111 Reporting Updates
by J. Shymanski NOTE: CMS experienced technical issues during the webinar and attendees were only able to join via the telephone conference line with no ability to ask questions live....
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CMS Publishes NGHP Section 111 User Guide Version 7.5
by F. Fairchok The Centers for Medicare & Medicaid Services (CMS) published an update to the Non-Group Health Plan (NGHP) Section 111 Reporting User Guide on April 1, 2024. This...
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CMS to Review Expansion of TPOC Reporting During Webinar on April 16
The Centers for Medicare & Medicaid Services (CMS) will host another webinar on Tuesday, April 16, 2024 at 2:00 pm ET regarding the expansion of Section 111 NGHP Total...
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CMS Issues Alert for Expansion of Section 111 NGHP Reporting to Include Data for WCMSA Arrangements
by M. Heberling The Centers for Medicare & Medicaid Services (CMS) issued a Technical Alert on February 23, 2024, related to changes to worker’s compensation Section 111 Reporting for Non-Group...
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How Healthy Are Your Tax Identification Number (TIN) Reference Files?
by P. Czuprynski Responsible Reporting Entities (RREs) need to report Ongoing Responsibility for Medical (ORM) or Total Payment of Obligation to Claimant (TPOC) associated with a workers’ compensation or liability...
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CMS Publishes NGHP Section 111 User Guide Version 7.4
by F. Fairchok The Centers for Medicare & Medicaid Services (CMS) published an update to the Non-Group Health Plan (NGHP) Section 111 Reporting User Guide on January 22, 2024. This...