What claims are Section 111 reportable, and when are they to be reported?
There are multiple factors to consider when determining if a claim is reportable and when it should be reported to Medicare. In fact, CMS published nearly 4000 words on
Level Three Conditional Payment Appeals: Where Three Months Means More Than Three Years
What is supposed to happen and what actually happens for level three conditional payment appeals?
Constitutional Challenge to Treasury Offsets in Conditional Payments Falls Flat: Massachusetts Man’s Moon Shot Lands with a Thud
A Federal Magistrate in a Massachusetts Federal Court dismissed a Navy veteran’s attempt to have the reliance upon Treasury offsets to collect Medicare conditional
Medicare Advantage Update: New Case in Connecticut
Anew decision from United States federal court in Connecticut opens the door for Medicare Advantage organizations (MAOs) to use the Medicare Secondary Payer statutes
Workers’ Compensation Review Contractor Protest
In September of this year the Centers for Medicare & Medicaid Services (CMS) announced the award of a new Workers’ Compensation Review Contractor (WCRC) contract to
Movement in the MSP Compliance Realm? Update on Liability and No-Fault Medicare Set-Asides
In a previous Industry News Bulletin, we noted that CMS seemed to be taking affirmative first steps on Liability Medicare Set-Aside Arrangements (LMSAs) and No-Fault
Why does the MSP industry use the phrase “consider and protect” when discussing Medicare’s interest?
Recently you may have seen some back and forth about the plain language of the Medicare Secondary Payer (MSP) Statute found at 42 USC 1395y(b). The discussion focused on
CMS Takes First Steps on LMSAs
Last week CMS released a change request to modify Medicare’s Common Working File (CWF) to address a new Liability Medicare Set-Aside (LMSA) policy. The announcement
California Federal Court: CMS May Not Seek Reimbursement for Conditional Payments That are Unrelated to the Claim
On January 5, 2017 in the matter of California Insurance Guarantee Association (CIGA) v. Burwell(i), a Federal Court granted CIGA’s Motion for Partial Summary Judgment