The Official Medicare Set Aside Blog And Information Resource

Medicare’s Conditional Payment Recovery Process is Ramping Up:  What You Need to Know.

Conditional Payments, CRC, MSP News on November 14, 2018
Posted by Jean S. Goldstein, JD

Last month, at the annual National Alliance of Medicare Set-Aside Professionals’ Annual Conference, Performant Financial (Performant), the current contractor for the Commercial Repayment Center (CRC), held a timely panel question and answer session.  You may recall that we recently blogged about how the current conditional payment recovery process continued to terrorize many non-group health plans.  […] Continue

NAMSAP Bulletin Provides a Sneak Peek into CMS’ LMSA Review Program

CMS, Liability, MSP News on August 13, 2018
Posted by Jean S. Goldstein, JD

Last week, the National Alliance of Medicare Set Aside Professionals (NAMSAP), through their Liability Medicare Set Aside (LMSA) Committee issued a special edition bulletin about LMSAs.  The bulletin described an April 16, 2018 meeting between NAMSAP members and the Centers for Medicare & Medicaid Services (CMS).  The informational bulletin, which is subject to change until […] Continue

Industrial Commission of Arizona Issues Advisory Document Outlining Best Practices for Full and Final Settlements

Medicare Set-Aside Blog, MSP News, State Regulations on July 23, 2018
Posted by Jean S. Goldstein, JD

The Administrative Law Judge Division of the Industrial Commission of Arizona has issued guidance for cases involving full and final settlements, in the form of an informative and suggested best practices document.  The document can be found here, and applies to full and final settlements that take place on or after August 3, 2018.  You […] Continue

U.S. Attorney’s Office Settles Conditional Payments Debts with Personal Injury Law Firm and Requires Attorney to Institute Best Internal Compliance Practices

Conditional Payments, Medicare, MSP News on June 20, 2018
Posted by Jean S. Goldstein, JD

On Monday, the U.S. Department of Justice’s Attorney’s Office for the Eastern District of Pennsylvania issued a press release concerning a settlement arrangement involving the repayment of conditional payments.  U.S. Attorney William M. McSwain announced that the Philadelphia personal injury law firm, Rosenbaum & Associates, and its principal, Jeffrey Rosenbaum entered into a settlement agreement […] Continue

How Will Mandatory Reporting Be Affected by CMS’ Announcements Regarding Thresholds?

CMS, Mandatory Insurer Reporting, Medicare Set-Aside Blog, MSP News on December 13, 2016
Posted by Jean S. Goldstein, JD

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

NGHP MMSEA Section 111 User Guide Version 4.7 Released

CMS, Mandatory Insurer Reporting, MSP News on July 14, 2015
Posted by Jessica M. Wingenroth, JD

In their fourth update this year, CMS applied four change requests to Version 4.7 of the NGHP MMSEA Section 111 User Guide. All changes incorporated information published in prior Alerts. Within Version 4.7 you can find the new: Recovery Agent process with dedicated fields, eliminating the prior TPA workaround; Section 111 Coordination of Benefits Secure […] Continue