The Official Medicare Set Aside Blog And Information Resource

Best Practices for Conditional Payment Appeals and More Questions Answered by the CRC and CMS MSP Operations Team

CMS, Conditional Payments, CRC, Medicare Set-Aside Blog on October 2, 2020
Posted by Jessica M. Wingenroth, JD

Last week representatives from the Commercial Repayment Center (CRC) and Centers for Medicare and Medicaid Services (CMS) Medicare Secondary Payer (MSP) Operations teams hosted a webinar on best practices for conditional payment redetermination requests for Non-Group Health Plan (NGHP) payers. The presentation included a review of the five levels of the Medicare appeals process, the […] Continue

CMS Webinar August 13, 2020 Section 111 Mandatory Insurance Reporting for Non-Group Health Plans (NGHP). Questions and Answers Now Available

CMS, Mandatory Insurer Reporting, Medicare Set-Aside Blog on September 18, 2020
Posted by Noel D. Sturtz, Client Program Manager

Following up on our July 15, 2020 Blog, The Centers for Medicare & Medicaid Services (CMS) has released to the public the August 13, 2020 Section 111 NGHP Reporting webinar and Questions and Answers document. The presentation highlighted Section 111 reporting tips, best practices, and reminders, as well as Medicare Secondary Payer Recovery Portal (MSPRP) […] Continue

Eleventh Circuit Extends the Scope: Who Else is Entitled to Double Damages Under the MSP?

Medicare Advantage, Medicare Set-Aside Blog, MSP Litigation on September 15, 2020
Posted by Jean S. Goldstein, JD, CMSP

A recent decision out of the U.S. Circuit Court of Appeals for the Eleventh Circuit has extended the scope of who may bring a private cause of action under the Medicare Secondary Payer Act [1] and may therefore be entitled to double damages.  The case is MSP Recovery Claims, Series LLC v. Ace American Insurance Company, et. […] Continue

CMS to Host Webinar on NGHP Appeals

CMS, Conditional Payments, Medicare Set-Aside Blog on August 25, 2020
Posted by Jean S. Goldstein, JD, CMSP

The Centers for Medicare & Medicaid Services (CMS) recently announced that it will be hosting a Commerical Repayment Center (CRC) Non-Group Health plan appeals webinar on September 24, 2020 to review the procedures and best practices for redeterminations (first-level appeals). The complete webinar information is available in the Downloads section of the Coordination of Benefits […] Continue

Shark Week and MSP Compliance: What Do They Have In Common?

CMS, Conditional Payments, Medicare Set-Aside Blog, Medicare Set-Asides, MSAs on August 14, 2020
Posted by Jean S. Goldstein, JD, CMSP

Shark Week is always a magical week; providing enthralling and illuminating insight into jaw-dropping actions of magnificent beings.  As with previous years, Shark Week 2020 has not been a disappointment, but how does shark week compare to Medicare Secondary Payer (MSP) compliance?  Our latest white paper addresses the three main goals of MSP compliance, and what consequences result for […] Continue