Blog
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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 Releases New WCMSA Reference Guide Version 4.0
by M. Heberling On April 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued version 4.0 of their Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) User Guide. CMS added...
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Court Determines Medicare Advantage Lien Was Invalid in Wrongful Death Med-Mal Action
By B. Smith In Meador v. United States (D. Mass. Feb. 13, 2024)[1], plaintiffs filed a wrongful death action and loss of consortium claim arising from treatment the decedent, an...
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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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Medicare Advantage Plans: Navigating Conditional Payment Appeals
by P. Czuprynski Federal regulations require Medicare Advantage Plans (MAPs) establish an administrative appeal process that allows a Qualified Independent Contractor, an Administrative Law Judge, the Medicare Appeals Council, and...
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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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CMS Issues Two New Alerts on Valentine’s Day: Reporting Threshold for 2024 and New Life Tables
The Centers for Medicare & Medicaid Services (CMS) issued two separate alerts on February 14. This first involves the reporting threshold for 2024 and the second is related to...
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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...