The Official Medicare Set Aside Blog And Information Resource

CMS Releases Updated Section 111 NGHP User Guide; Still No Word On Civil Money Penalties

CMS, Mandatory Insurer Reporting, MSP News on October 16, 2019
Posted by Jean S. Goldstein, JD

Many of us in the industry continue to wait with bated breath for information related to a proposed rule for Civil Money Penalties for Medicare Secondary Payer (MSP) Reporting.  You may recall our recent blog postings announcing an advanced notice of a proposed rule involving MSP reporting, and a subsequent update to the notice, which […] Continue

CMS Updates Unified Agenda Regarding Date for Civil Money Penalty Provisions for MSP Reporting Requirements

CMS, Mandatory Insurer Reporting, MSP News on August 12, 2019
Posted by Jean S. Goldstein, JD

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 money penalties for MSP […] Continue

CMS Issues Updated Section 111 User Guide and Updated WCMSA Portal User Guide

CMS, Mandatory Insurer Reporting, Medicare Set-Asides on July 19, 2019
Posted by Jean S. Goldstein, JD

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

MSP Reporting Penalties…Are Reporting Penalties Finally Coming to Fruition?

CMS, Mandatory Insurer Reporting, MSP News on December 12, 2018
Posted by Jean S. Goldstein, JD

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

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