Pharmacy Red Flags in Treatment of Injured Workers
Given the nature of workers’ compensation injuries, many claims contain one or several pain-reducing agents. Use of these agents puts the patient at higher risk for
CMS to Hold PAID Act Webinar
The Centers for Medicare & Medicaid Services (CMS) announced that it will hold a webinar on June 23rd at 1 pm ET regarding the upcoming PAID Act implementation. The
CMS Continues Slow-Motion Section 111 Reform
As we have outlined a number of times over the last several months, the Centers for Medicare & Medicaid Services (CMS) is conducting a slow-motion reform of Section 111
CMS Releases Updated Section 111 User Guide
The Centers for Medicare & Medicaid Services (CMS) released an updated NGHP User Guide to coincide with last week’s launch of the new “soft edit” process in Section 111
“Soft” Edits Debut Today in Section 111 Reporting
Today marks the first significant update in Section 111 reporting logic in several years. In November 2020 the Centers for Medicare and Medicaid Services (CMS) announced
Joint CMS, BCRC & CRC Conference Call Recap
No fooling, the Centers for Medicare & Medicaid Services (CMS), Benefits Coordination and Recovery Contractor (BCRC), and Commercial Repayment Center (CRC) got together
Ask Annie: Total Settlement Amount v. Total Payment Obligation to the Claimant
Question: We are settling a workers’ compensation claim with a Medicare beneficiary for $25,000 on a full, final, and complete basis closing out all future medical on
The PAID Act: Offering Hope to Coordinate Medicare Advantage Claims
On December 11, 2020, the MARC Coalition succeeded in its efforts to have Congress enact the Provide Accurate Information Directly (“PAID”) Act, filling a gaping hole in