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 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

A New User Guide and New Functionality Added

Conditional Payments, Medicare Secondary Payer Recovery Portal, Medicare Set-Aside Blog on July 13, 2020
Posted by Jean S. Goldstein, JD, CMSP

Last month, we blogged about new functionality to the Medicare Secondary Payer Recovery Portal (MSPRP) to allow authorized users to view and print correspondence via the portal, which is now accessible.  This is beneficial when correspondence related to the conditional payment recovery process has not been received.  In addition, today, a new MSPRP User Guide […] Continue

MSP Court Decision Sends Warnings Signals to Primary Payers

Conditional Payments, Medicare Set-Aside Blog, MSP Litigation on July 7, 2020
Posted by Jean S. Goldstein, JD, CMSP

A recent decision out of the United States District Court for the District of New Jersey is sending warning signals and a reminder to implement proactive practices to primary payers. The decision arises from Osterbye v. United States, 2020 U.S. Dist. LEXIS 116591, and came before the court on the Defendant’s Motion to Dismiss Plaintiff’s […] Continue