Blog
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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 Releases Updated Self-Administration Toolkit Version 1.5
by J. Shymanski While dated May 15, 2024, the Centers for Medicare & Medicaid Services (CMS) released version 1.5 of the Self-Administration Toolkit for Workers’ Compensation Medicare Set-Aside Arrangements (WCMSAs)...
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Medicare Provides Forms to Close CRC and BCRC Cases
by P. Czuprynski On May 13, 2024, Medicare issued two new forms that can be used to request that Medicare close a Commercial Repayment Center (CRC) or Benefits Coordination &...
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Is CMS Still Approving Zero-Waiver MSAs?
by D. Dietz Yes, the Centers for Medicare and Medicaid Services (CMS) is still approving Zero-Waiver Medicare Set-Asides (MSAs) on a case-by-case basis. Approval is based on documentation provided to...
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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 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...