Last week, we provided an update that the Centers for Medicare and Medicaid Services (CMS) updated the Unified Agenda as related to the proposed rulemaking for guidance regarding how to satisfying Medicare Secondary Payer (MSP) obligations. The Unified Agenda was also recently updated with respect to the proposed rule regarding civil monetary penalties for MSP […] Continue
The Centers for Medicare and Medicaid Services (CMS) released two new updated guides earlier this month: an updated Section 111 Medicare Secondary Payer Reporting User Guide, and an updated Workers’ Compensation Medicare Set-Aside Portal User Guide. Both of these guides contain very minor updates, which will not have a significant impact on the claims handling process. […] Continue
The Medicare Medicaid SCHIP Extension Act of 2007 (MMSEA) imposed Mandatory Insurer Reporting obligations on all Responsible Reporting Entities (RREs). These mandatory requirements impart obligations on RREs, and require these entities to provide the Centers for Medicare and Medicaid Services (CMS) with data on claims that involve Medicare beneficiaries. Furthermore, pursuant to the Strengthening Medicare […] Continue
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
CMS updated their Non-Group Health Plan (NGHP) User Guide, and released version 5.2. The updated guide can be found here. The only update to the guide is the change in thresholds for reporting certain cases with total payment obligation to the claimant (TPOC), as indicated in CMS’ recently issued alerts and as previously discussed here […] Continue