Second Circuit Falls in Line on Medicare Advantage
Medicare Advantage Plans remain largely undefeated. For the last decade, MAPs have pulled off an impressive streak of wins as they – in an attempt to collect direct
2022 Updated CDC Guidelines for Prescribing Opioids – What’s New and What’s Changed?
T he CDC Guideline for Prescribing Opioids for Chronic Pain – United States, 2022, 2022 Clinical Practice Guideline updates and replaces the 2016 Guideline for
CMS Publishes Medicare Set-Aside Statistics
On November 1, 2022, for the first time in recent memory, the Centers for Medicare & Medicaid Services (CMS) made the WCMSA Fiscal Year Statistics 2020-2022 available on
Why You (or Your Recovery Agent) Should Go Paperless Right Now
L ate last year, the Centers for Medicare & Medicaid Services (CMS) and its coordination of benefits contractor, the BCRC, soft launched a process to largely eliminate
Epic Game of Kick the Can Regarding LMSAs Comes to an End: CMS 0, Stakeholder Community 2
Yesterday, the Office of Information and Regulatory Affairs (OIRA) at the White House’s Office of Management and Budget (OMB) issued notice that the Center for Medicare
WCMSA Submissions Slow Down
Noticing an uptick in the time it takes to get the Centers for Medicare and Medicaid Services (CMS) to approve that Workers’ Compensation Medicare Set-Aside (WCMSA) you
Section 111 Reporting: A Path to Better Reporting
It has been a long and winding road since the inception of Section 111 reporting, covering 14 years, more than 35 revisions to the Non-Group Health Plan (NGHP) User
Three Rules for “Surviving” Liability MSAs
As our loyal readers are all-too-well aware, we’ve been awaiting written regulatory proposals regarding liability Medicare Set-Asides (MSA) for a number of years. ECS
SCOTUS on Medicaid Recovery: Breaking Down the Gallardo v. Marstiller Decision
This week the U.S. Supreme Court issued its 7-2 decision in Gallardo v. Marstiller, 2022 U.S. LEXIS 2683. The Court held that the “Medicaid Act permits a State to seek