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
CMS recently announced a change in the reporting thresholds to $750 for liability settlements, and advised that it would maintain the $750 threshold for no-fault and workers’ compensation settlements, where the insurer or entity does not otherwise have ongoing responsibility for medicals (ORM). Just yesterday, CMS issued a technical alert regarding the change in reporting […] Continue
Updates to the NGHP User Guide have been released. The updates are minor, and reflect only the references which are available under the Reference Materials menu found on the Coordination of Benefits Secure Website (COBSW). The updates of the chapters of the user guide are: Chapter I- Introduction and Overview and Chapter 2- Registration Procedures: […] Continue