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Expert Insight into the Latest News & Updates for Medicare Secondary Payer Compliance

Section 111 Civil Money Penalties Proposed Rule Unveiled: The Risk of Getting Section 111 Wrong

Section 111 Civil Money Penalties Proposed Rule Unveiled: The Risk of Getting Section 111 Wrong

The long-awaited proposed rule on Section 111 civil money penalties was unveiled in the Federal Register for public inspection. The draft of the proposed rule can be

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February 14, 2020
Ask Annie: The Amended Review Process in Detail

Ask Annie: The Amended Review Process in Detail

Question: We have a case that couldn’t be settled due to a counter-higher in 2014. The claimant’s treatment has decreased dramatically. What options are available for us?

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January 21, 2020
Philadelphia U.S. Attorney Nets Another Recovery for Unpaid Medicare Debts

Philadelphia U.S. Attorney Nets Another Recovery for Unpaid Medicare Debts

The U.S. Department of Justice (“DOJ”) is ringing in the New Year with the Medicare Secondary Payer Act (“MSPA”). On January 8, 2020, the U.S. Attorney’s Office for the

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January 14, 2020
Updates from CMS Regarding NGHP Processes

Updates from CMS Regarding NGHP Processes

CMS has posted two updates this week:

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December 6, 2019
Ask Annie: Mythical Zero Allocations

Ask Annie: Mythical Zero Allocations

Question: I’ve heard that zero allocations are getting more and more challenging. Please level with me, will Medicare approve a zero allocation in a denied case? If so,

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December 5, 2019
OMB Updates Timeline Civil Money Penalty and Future Medical Regulations

OMB Updates Timeline Civil Money Penalty and Future Medical Regulations

That can? It’s still getting kicked. Earlier this week the White House Office of Management and Budget updated the timeline on the release of regulations involving

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November 21, 2019
Baltimore U.S. Attorney Nabs Another Plaintiff’s Firm: Obtains $91,000 Settlement to Resolve Allegations a Firm Failed to Reimburse Medicare

Baltimore U.S. Attorney Nabs Another Plaintiff’s Firm: Obtains $91,000 Settlement to Resolve Allegations a Firm Failed to Reimburse Medicare

As you may recall, we have been down this road before with a different Baltimore law firm and a Pennsylvania practitioner. Standard operating procedure when settling a

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November 12, 2019
CMS Updates WCMSA Reference Guide: Key Changes in Store

CMS Updates WCMSA Reference Guide: Key Changes in Store

Late on Tuesday October 29th the Centers for Medicare & Medicaid released an update, version 3.0 to its WCMSA Reference Guide (Guide). The new version of the guide

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October 31, 2019
Rolling Recovery of Conditional Payments Impacts Non-Closure States

Rolling Recovery of Conditional Payments Impacts Non-Closure States

Once again insurers and self-insured employers have been hit with a substantial amount of new paperwork from the Centers for Medicare & Medicaid Services (CMS). Medicare

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October 28, 2019
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