The Official Medicare Set Aside Blog And Information Resource

CMS Increased Conditional Payment Demand by $142k: New York Supreme Court Vacates Settlement Agreement

CMS, Conditional Payments, Medicare Set-Aside Blog, MSP Litigation on March 26, 2018 | Posted by Jean S. Goldstein, JD

An interesting case came out of the Supreme Court of New York City on Friday, challenging whether a settlement agreement may be declared null and void based upon an erroneous assumption of the total sum of conditional payments made by Medicare.  Mayo v. NYU Langone Med. Ctr., 2018 NY Slip Op 30456(U) (Sup. Ct.). The parties litigated […] Continue

New CRC Contractor: What Are Our First Impressions?

Conditional Payments, CRC, Medicare Set-Aside Blog, MSP News, WCRC on March 20, 2018 | Posted by Jean S. Goldstein, JD

It’s been over a month since the anticipated transition of the Commercial Repayment Center (CRC) contractor from CGI Federal to Performant Recovery.  Our first impressions have all been positive.  As with all transitions to new government contractors, we of course had some reservations and concerns, but to date are encountering only positive experiences. Some quick […] Continue

CRC Contractor Transition Webinar Slides Available for Review

Conditional Payments, CRC, Medicare Set-Aside Blog, MSP News on January 26, 2018 | Posted by Jessica M. Wingenroth, JD

CRC Webinar Slides Available for Review If you missed the January 18th webinar introducing the incoming Commercial Repayment Center Contractor, Performant Recovery, Inc., those slides are now available for review. The presentation may be accessed via the Downloads section on the Coordination of Benefits & Recovery, What’s New page. You can also review our summary […] Continue

The CRC Dark Days are Coming, February 8 – 9, 2018

Conditional Payments, CRC, Medicare Set-Aside Blog, MSP News on January 18, 2018 | Posted by Jessica M. Wingenroth, JD

The highly anticipated Commercial Repayment Center (CRC) contractor transition from CGI Federal to Performant Recovery was discussed in a CMS Town Hall presentation this afternoon. The stated goal: seamless, painless and efficient transition with zero impact on Coordination of Benefits and Recovery activity. Ted Doyle, the project director of the incoming MSP CRC, assured the […] Continue

Meet the New CRC Contractor on 01/18/18

Conditional Payments, CRC, Medicare Set-Aside Blog, MSP News on January 15, 2018 | Posted by Jessica M. Wingenroth, JD

The industry has been invited to a CMS-sponsored webinar to introduce the new Commercial Repayment Center (CRC) contractor, Performant Financial Corporation, who will be taking up residence effective 02/08/18. As part of the transition, an informational webinar will be held for Non-Group Health Plan (NGHP) payers on 01/18/18 at 1:00 pm ET. A link to […] Continue

Full Medicaid Recovery Coming to a Claim Near You: October 1st

Conditional Payments, Medicaid, Medicare, Medicare Set-Aside Blog, MSP News on September 25, 2017 | Posted by Jean S. Goldstein, JD

As we have seen, Medicare Advantage Plans, Military/Governmental Healthcare Providers, and Private Insurers are aggressively pursuing liens with a priority right approach to recovery.  We often discuss these entities in the context of being a secondary payer, and the omnipresent concern that these entities will seek reimbursement of payments that have been conditionally made, when […] Continue

CIGA Wins Partial Summary Judgment on Issue of Over-inclusive Reimbursements

Conditional Payments, Jen Article, Medicare Set-Aside Blog, MSP Litigation on January 9, 2017 | Posted by Jennifer Jordan, JD, MSCC

On January 5, 2017, the U.S. District Court for the Central District of California ruled in favor of the California Insurance Guarantee Association (CIGA) in its ongoing challenges against CMS over its MSP practices. After several years and many amended complaints, the only remaining issue in this litigation was CIGA’s allegations that CMS calculates its […] Continue

Teleconference Call Recap: CMS and CRC Address Delays and Enhancements  

CMS, Conditional Payments, CRC, Medicare Set-Aside Blog, MSP News on November 21, 2016 | Posted by Jean S. Goldstein, JD

On Thursday, November 17, the Centers of Medicare and Medicaid Services’ (CMS) held a teleconference, with both CMS representatives and Commercial Repayment Center (CRC) representatives available to provide long awaited explanations.  The call served as a general update for cases processed through the CRC, as a means to issue reminders to stakeholders, and to allow […] Continue

CMS Issues Alert Regarding Conditional Payment Recovery Thresholds

CMS, Conditional Payments, Mandatory Insurer Reporting, Medicare Set-Aside Blog on September 29, 2016 | Posted by Jean S. Goldstein, JD

Yesterday, CMS issued an alert implementing a $750 threshold for no-fault insurance and workers’ compensation entities that do not otherwise have an ongoing responsibility for medicals.  This new thresholds means that CMS will not seek recovery of conditional payments made on workers’ comp or no-fault claims falling under the $750 threshold, as long as there […] Continue

Final Rule Regarding Expansion of the Functionality of the Medicare Secondary Payer Recovery Portal

CMS, Conditional Payments, MSP News on May 19, 2016 | Posted by Erin O'Neill, PA-C, JD

On May 17, 2016, The Centers for Medicare and Medicaid Services (CMS) released the final rule, specifying the timeline and process for expansion of the current Medicare Secondary Payer Recovery Portal. The Final Rule, entitled Medicare Program; Obtaining Final Medicare Secondary Conditional Payment Amounts via Web Portal was published in the Federal Register and can […] Continue

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