Blog
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CMS Extends Timeline for Publication of Final Rule for Section 111 Civil Monetary Penalties by One Year
by B. Smith On the three year anniversary of the Section 111 Proposed Rule for Civil Monetary Penalties (CMPs) the Centers for Medicare & Medicaid Services (CMS) filed a notice...
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Eight Lessons Learned about MSP Compliance in 2022 (Part 2) – WorkCompWire
Co-CEOs Jon Gunter and Barbara Fairchild recently wrote a two-part article for WorkCompWire's Leaders Speak feature, Eight Lessons Learned about MSP Compliance in 2022, where they provide their insights...
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Eight Lessons Learned about MSP Compliance in 2022 (Part 1) – WorkCompWire
Co-Chief Executive Officers Barbara Fairchild and Jon Gunter recently wrote a two-part article for WorkCompWire's Leaders Speak feature, Eight Lessons Learned about MSP Compliance in 2022, where they provide...
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CMS Issues Memo on MSP Obligations When Settling Alleged Exposure Claims
by B. Smith On January 20, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a memo entitled Medicare Secondary Payer (MSP) Obligations and Settlements Related to Alleged Exposure...
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CMS Publishes NGHP User Guide Version 7.0
by F. Fairchok CMS published an update to the NGHP User Guide on January 9, 2023. In addition to several minor updates, Version 7.0 announced a new Unsolicited Response File...
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Medicare Advantage Plans: PAID ACT – Year One
by P. Czuprynski Carriers and self-insureds, or their vendors, have the ability to ask Medicare if a particular claimant is enrolled in Medicare benefits through either an electronic data request or...
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CMS Will Maintain $750 Recovery Threshold for 2023
The Centers for Medicare & Medicaid Services (CMS) is required to publish an annual threshold for recovery each year. This threshold amount reflects an amount for which CMS will...
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Key Takeaways from CMS’ NGHP Reporting Webinar
by F. Fairchok CMS hosted a webinar on December 6, 2022, to discuss best practices for Section 111 Reporting for Non-Group Health Plan (NGHP) entities. The one-hour webinar began with...
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CMS Issues New WCMSA Reference Guide Version 3.8
By B. Smith Yesterday, CMS released version 3.8 of their Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide, which now includes an additional Re-Review option when the parties wish to...