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
Last week a Medicare Secondary Payer (MSP) case out of the 11th Circuit Court was issued (MSPA Claims 1, LLC v. Scottsdale Ins. Co., No. 18-21525-CIV-MORE, 2018 U.S. Dist. LEXIS 218675 (S.D. Fla. Dec. 12, 2018). The facts of the case essentially mirror recent other cases that we have seen: Plaintiff, MSPA Claims 1, LLC […] 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
As we blogged last week, the Medicare Secondary Payer Recovery portal (MSPRP) has undergone some recent enhancements, and an informative webinar was recently held to provide an overview of these enhancements. The most recent enhancements are a new self-reporting feature and a new multi-factor authentication process. Most significant for those who use the MSPRP, is […] 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
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
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
Starting January 5, 2019, the Centers for Medicare and Medicaid Services (CMS) will begin using the CDC’s “Table 1: Life Table for the total population: United States, 2015” for Workers’ Compensation Medicare Set Aside (WCMSA) life expectancy calculations. This means that for any WCMSA proposal received by CMS, or where any WCMSA case is reopened […] Continue