Blog
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CMS Maintains $750 Recovery Threshold for 2025
CMS is required to publish an annual threshold for recovery each year. This threshold amount reflects an amount for which CMS will not spend more on collections than a...
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CMS Issues NGHP User Guide Version 7.8
by B. Smith The Centers for Medicare & Medicaid Services (CMS) has issued a new Non-Group Health Plan (NGHP) User Guide, Version 7.8. CMS added a new language in Chapter...
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Administrative Procedure Act: Medicare, Medicare Advantage and Prescription Plans Must Follow its Regulations
With Chevron Deference being overturned, stakeholders facing conditional payment demands or payment denials by Medicare have a better chance of success in challenging Medicare’s decision. Federal district court review of...
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Success Spotlight: Persistence in the Re-Review Process Results in Savings of 65K
by K. Kline Advancing customer interests through the effective use of the Centers for Medicare & Medicaid Services (CMS) re-review process continues to be an important part of IMPAXX’s Workers’...
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CMS NGHP Civil Money Penalties Webinar and Slide Release
by B. Smith Updated: 11/25/24 – CMS provided a link to updated slides (now including Q&A) from their September 12 webinar on the What’s New page of the Mandatory Insurer Reporting for NGHP section on CMS.gov. On October 17,...
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Testing Now Available for Upcoming Change to S111 Work Comp Reporting
Responsible Reporting Entities (RREs) can now test file layout changes for the upcoming change to S111 Workers’ Compensation reporting effective April 4, 2025. RREs should coordinate testing with their...
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CMS Updates ICD-10 and ICD-9 Valid Code Lists for 2025
The Centers for Medicare & Medicaid Services (CMS) published updated ICD-10 and ICD-9 valid and excluded liability and no-fault code lists for 2025 on October 21, 2024. Valid ICD-10...
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CMS Updates NGHP User Guide to Version 7.7
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 October 7, 2024. The...
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MSPN Annual Conference Recap
By M. Heberling and D. Dietz The National MSP Network held their annual educational conference on September 25-27. This was an exciting year to be at the conference as there...