Blog
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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...
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CMS to Host Section 111 NGHP Reporting Webinar on Dec. 6
CMS will be hosting a Section 111 Non-Group Health Plan (NGHP) reporting webinar on Wednesday, December 6 at 2:00 pm ET. They will kick off the webinar with opening remarks...
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Medicare Set-Aside Statistics 2020-2022 Continue to Show Increase in Submitted MSA Amounts
by B. Smith This week, the Centers for Medicare & Medicaid Services (CMS) released the 2020-2022 fiscal year statistics for Workers’ Compensation Medicare Set-Asides (WCMSAs) that have been submitted to...
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CMS Now Consistently Requesting Expense Payment Histories
by J. Mislanovich The Centers for Medicare & Medicaid Services (CMS) WCMSA Reference Guide has always indicated that an all-inclusive payment history (including medical, indemnity, and expenses) is to be...