End-of-Year Update: PAID Act and Post-Settlement Regulations
December is always a busy month in Medicare Secondary Payer compliance and 2020 is no different. This week we have witnessed important developments in legislation and
Maintaining Status Quo: CMS Retains $750 TPOC and Recovery Threshold
True to form, the Centers for Medicare & Medicaid Services (CMS) released another Alert during a holiday weekend. This time, on the day before Thanksgiving Day, CMS
CMS Announces Section 111 Technical Updates
On Thursday November 12th the Centers for Medicare & Medicaid Services (CMS) released an alert and an updated Section 111 NGHP User Guide to improve data quality
Ask Annie: Complex Settlements, Simplified
Question: We are settling a complicated claim involving a claimant’s lower back. Over the course of the claimant’s workers’ compensation claim they added a number of
CMS Updates Workers’ Comp Settlement Guidance
Following an August Town Hall call that addressed workers’ compensation indemnity-only settlements, the Centers for Medicare & Medicaid Services (CMS) made significant
Spotlight on TOP Program: Offsets Hit 9/11 Fund
When Medicare conditional payment demands go unpaid, the debt is referred to the U.S. Department of Treasury for direct collection and offset. The Treasury Department’s
Closing the Loop on Trostle: USDOJ Did Not Satisfy “Must File” Provision of MSP Regulations So Netted $54,000 Instead of $84,000
On Friday, August 21, 2020, the United States Department of Justice released notice it had reached a settlement with Angino Law Firm to accept almost $54,000 in
CMS Holds Section 111 Town Hall Call
For the first time in several years, the Centers for Medicare & Medicaid Services held a Section 111 NGHP Town Hall webinar. The webinar focused on common issues that
Falling Oxycodone Prices and FDA Requirement for Labeling Changes
We continue to have falling opioid prices with the latest being the oxycodone formulations. While opioid volume and costs are on a downward trend in utilization, per