The Official Medicare Set Aside Blog And Information Resource

CMS Will Maintain $750 Recovery Threshold for 2019

CMS, Conditional Payments, Mandatory Insurer Reporting on November 21, 2018
Posted by Jean S. Goldstein, JD

The Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act) requires the Centers for Medicare & Medicaid Services (CMS) to publish an annual threshold for recovery in November, each year.  This threshold amount reflects an amount for which CMS will not spend more on collections than a claim is likely to yield.  In […] Continue

Medicare’s Conditional Payment Recovery Process is Ramping Up:  What You Need to Know.

Conditional Payments, CRC, MSP News on November 14, 2018
Posted by Jean S. Goldstein, JD

Last month, at the annual National Alliance of Medicare Set-Aside Professionals’ Annual Conference, Performant Financial (Performant), the current contractor for the Commercial Repayment Center (CRC), held a timely panel question and answer session.  You may recall that we recently blogged about how the current conditional payment recovery process continued to terrorize many non-group health plans.  […] Continue

Conditional Payments: When Does the Time Clock Run Out?

Conditional Payments, Medicare Advantage, MSP Litigation on October 1, 2018
Posted by Jean S. Goldstein, JD

Last week, in MSPA Claims 1 v. Kingsway Amigo Ins. Co.,  the 11th Circuit addressed the appropriate application of the statute of limitations under the Medicare Secondary Payer Act (MSPA).  At issue in the matter, was whether the Plaintiff, an assignee of a Medicare Advantage Organization (MAO), timely pursued a claim against the Defendant, a primary […] Continue

Medicare Secondary Payer Recovery Portal (MSPRP) Overview Webinar Slides Now Available

CMS, Conditional Payments, MSP News on August 23, 2018
Posted by Jean S. Goldstein, JD

Last week, we posted about CMS’ overview webinar regarding the benefits of using the Medicare Secondary Payer Recovery Portal (MSPRP), a web-based application for managing Medicare recovery cases (or conditional payments).  The webinar slides from the webinar are now available for download here. If you have additional questions concerning the current functionality of the MSPRP, […] Continue

CMS Provides High Level Overview of MSPRP and Insight into Future Enhancements

CMS, Conditional Payments, MSP News on August 17, 2018
Posted by Jean S. Goldstein, JD

Yesterday, the Centers for Medicare & Medicaid Services (CMS), held an informative webinar to address the benefits of using the Medicare Secondary Payer Recovery Portal (MSPRP), a web-based application for managing Medicare recovery cases (or conditional payments).  The webinar was an overview explaining the various benefits of using the MSPRP, how to get started using […] Continue

Shark Week May be Over; but the Conditional Payment Recovery Process Continues to Terrorize

Conditional Payments, Medicare, MSP News on August 9, 2018
Posted by Jean S. Goldstein, JD

Shark Week is a magical week; providing some of the most enthralling and illuminating insight into jaw-dropping actions of magnificent beings.  As with previous years, Shark Week 2018 did not disappoint.  Many of us can recall learning in basic grade school science that sharks are a necessary evil to keep the ecosystem in a proper […] Continue

Medicare Secondary Payer Portal (MSPRP) Overview Webinar Scheduled for August 16, 2018

CMS, Conditional Payments, MSP News on July 31, 2018
Posted by Jean S. Goldstein, JD

You may recall we recently advised that CMS released an updated Medicare Secondary Payer Recovery Portal (MSRP) user guide, with the intention of creating more efficient practices.  CMS will be hosting a webinar to present the benefits of using the MSPRP, as well presenting the newly available features.  The webinar will be held on August […] Continue

CMS Releases Updated Medicare Secondary Payer Recovery Portal User Guide Noting Enhancements to the Portal

CMS, Conditional Payments, MSP News on July 10, 2018
Posted by Jean S. Goldstein, JD

CMS recently released an updated Medicare Secondary Payer Recovery Portal (MSRP) user guide in the hopes to lead to some more efficient practices.  A summary of the updates is as follows:   To reduce the number of calls received by the BCRC regarding the status of case correspondence, a new read-only Letter Activity tab has […] Continue

U.S. Attorney’s Office Settles Conditional Payments Debts with Personal Injury Law Firm and Requires Attorney to Institute Best Internal Compliance Practices

Conditional Payments, Medicare, MSP News on June 20, 2018
Posted by Jean S. Goldstein, JD

On Monday, the U.S. Department of Justice’s Attorney’s Office for the Eastern District of Pennsylvania issued a press release concerning a settlement arrangement involving the repayment of conditional payments.  U.S. Attorney William M. McSwain announced that the Philadelphia personal injury law firm, Rosenbaum & Associates, and its principal, Jeffrey Rosenbaum entered into a settlement agreement […] Continue