This blog series is devoted to better understanding the efforts our Federal government is undertaking to combat the opioid epidemic in America. Last year, the Department of Health and Human Services (HHS) announced a five-part strategy that will be utilized to combat the opioid epidemic. In previous posts, we have focused on the first four […] Continue
Next week, CMS will be holding a telephone call to discuss and answer questions regarding CMS’ new opioid policies for Medicare drug plans. CMS finalized new policies for the Part D plans to follow starting January 1, 2019. Through this initiative, CMS is seeking to strengthen and broaden its partnership with providers to address the […] Continue
Yesterday, CMS released Part II of a set of proposals that CMS indicates “will take significant steps in continuing the agency’s efforts to maximize competition among Medicare Advantage Plans (MAP) and Part D plans.” Part I of CMS’ proposal was released on December 20, 2018 and included proposed updates to the Part C risk adjustment […] Continue
On 01/15/19, the Centers for Medicare & Medicaid Services (CMS) opened a National Coverage Analysis (NCA) to complete a thorough review of the evidence to determine if acupuncture for chronic low back pain is reasonable and necessary under the Medicare program. The public comment period is open until 02/14/19, a proposed decision memo due date […] Continue
Earlier this week, the Centers for Medicare & Medicaid Services (CMS) issued a revised Workers’ Compensation Medicare Set-Aside (WCMSA) reference guide, which we first alerted our readers to here on our blog. Some of the changes found within the update guide addressed a few of the recent alarming CMS approval trends we have been tracking. […] Continue
It has certainly been a busy week for Medicare Secondary Payer news. Aside from a updated Worker’s Compensation Medicare Set-Aside reference guide being issued, there has also been an updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide and an updated MMSEA Section 111 NGHP User Guide issued. We have addressed many of the revisions […] Continue
An updated Workers’ Compensation Medicare Set-Aside Reference guide was issued today. The revised guide, version 2.9 can be found here. The updates in this guide are as follows: To eliminate issues around Development Letter and Alert templates auto populating with individual Regional Office (RO) reviewer names and direct phone numbers, these will now display the […] Continue
We recently blogged about a webinar held by the Centers for Medicare & Medicaid Services regarding the additional enhancements coming to the Medicare Secondary Payer Recovery Portal (MSPRP) this week. The webinar slides are now available for download here, and provide important information about the new self-reporting feature and the new multi-factor authentication process, as […] Continue
What would year end 2018 be without some additional news that may impact your claims? As our readers are likely aware, we are in a partial government shutdown, and on the surface, it may appear that many of us who deal with workers’ compensation claims will not be affected. However, you might be surprised how […] Continue
Today, the Centers for Medicare & Medicaid Services held a high level overview webinar of the upcoming Medicare Secondary Payer Recovery Portal (MSPRP) enhancements, which as you may recall we addressed in our recent blog post: Medicare Secondary Payment Recovery Portal (MSPRP) to Allow for Self-Reporting: Coming January, 2019. The purpose of the webinar was […] Continue