On July 13th the Centers for Medicare & Medicaid Services (CMS) released previously announced enhancements to the Medicare Secondary Payment Recovery Portal (MSPRP). The MSPRP “web-based tool” is designed to assist in the resolution of liability insurance, no-fault insurance, and workers’ compensation Medicare recovery cases. These enhancements reflect CMS’ continued efforts to supply self-service options to the… Read more »
Centers for Medicare & Medicaid Services (CMS) issued an alert to remind non-group health plan (NGHP) responsible reporting entities (RREs) that they must combine both Med Pay and personal injury protection (PIP) coverage limits when reporting claims to CMS via Section 111 mandatory insurer reporting.
The Centers for Medicare & Medicaid Services (CMS) announced on June 1, 2020 upcoming enhancements to the Medicare Secondary Payment Recovery Portal (MSPRP).
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 Medicare Set-Aside Arrangements (NFMSAs). Since the time of that writing, we have seen a few revisions to the change request notice provided to Medicare Administrative Contractors (MACs). The most recent… Read more »
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 establishes a timeline for back-end technical changes and provides clues to Medicare’s new policy. A copy of the notice can be found here. What does the change request say? To… Read more »
After announcing last month that CMS was reducing the recovery threshold for physical trauma-based liability settlements from $1,000 to $750 for 2017, CMS has now issued an Alert that as of 1/1/2017 the mandatory reporting threshold for liability insurance Total Payment Obligation to the Claimant (TPOC) Amounts dated 1/1/2017 or after is changing from $1,000… Read more »
CMS Implements $750 Settlement Threshold for WC Conditional Payment Recovery; Maintains $1,000 Threshold in Liability
A September 26, 2016 CMS Alert (Alert) announced the implementation of a $750 conditional payment recovery threshold for no-fault and workers’ compensation settlements. CMS also announced it is maintaining the $1,000 conditional payment recovery threshold for liability settlements, a threshold which has been in place since January 1, 2014. Implications Workers’ compensation and no-fault plans… Read more »
Federal Appellate Court Holds Medicare Advantage Plan Assignees May Maintain Claims for Reimbursement Against No-Fault and PIP Plans
The 11th Circuit U.S. Court of Appeals, which includes Florida, Alabama and Georgia under its jurisdiction, has found that Medicare Advantage Plans (MAPs) may assign their rights of recovery under the MSP Act to another party. The consequence of the ruling is that MAPs or their assignees may assert a claim for reimbursement against no-fault… Read more »
The Centers for Medicare and Medicare Services (CMS) is considering expanding the voluntary Workers’ Compensation MSA review process to include review of liability and no-fault insurance MSA amounts. The June 9, 2016 notice states as follows: The Centers for Medicare and Medicaid Services (CMS) is considering expanding its voluntary Medicare Set-Aside Arrangements (MSA) amount review… Read more »