Author Archives: BSmith

CMS Releases Documents from Section 111 NGHP Webinar

As a follow-up to the Section 111 NGHP webinar held on August 13, 2020, CMS has now released the slides from the webinar as well as the answers to various questions posed after the presentation.  NuQuest posted a prior blog on the highlights from this presentation which can be found here. Should you have any […]

New CMS Alert on Section 111 Webinar Presentation

CMS has released the August 13, 2020 Section 111 Non-Group Health Plan Reporting webinar presentation.  The presentation can be accessed on the download section of the Mandatory Insurer Reporting for Non-Group Health Plans What’s New page or through the following link: _https://www.cms.gov/files/document/august-13-2020-section-111-non-group-health-plan-reporting-webinar-presentation.pdf.  Questions and answers from the webinar will also be released by CMS in […]

CMS Issues New Section 111 Alert

Jun 12, 2020 by Bridget Smith, JD CMS Issues New Section 111 Alert for Reporting No-Fault Insurance Limit on Non-Group Health Plan (NGHP) Claim Input Files In this Alert dated June 8, 2020, CMS  reminds Non-Group Health Plan (NGHP) Responsible Reporting Entities (RREs)  that when reporting No-Fault Insurance Limits via Section 111 both Med Pay […]

CMS Issues New WCMSA Reference Guide 3.1

May 19, 2020 by Bridget Smith, JD CMS has released a new Workers’ Compensation Medicare Set-Aside Reference Guide, Version 3.1, May 11, 2020, COBR-Q2-2020-v3.1 a link to which can be found here:  https://www.cms.gov/files/document/wcmsa-reference-guide-version-31.pdf  This version of the Guide contained the new reference to  the CDC life table 2017 that CMS has been utilizing for the […]

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Medicare Advantage Organization Recovery Rights

In published opinion filed on March 18, 2019, the United States Court of Appeals for the 11th Circuit affirmed the district court’s dismissal of MSPA Claims 1, LLC (MSPA) for failure  to sue a “primary plan” pursuant the private cause of action provisions in the Medicare Secondary Payer Act (MSP Act). In MSPA Claims1, LLC […]

CMS Hosts MSPRP Electronic Payment Enhancement Webinar

The March 13, 2019 webinar offered by CMS provided a description of the new direct payment features available through the Medicare Secondary Payer Recovery Portal (MSPRP) as of April 1, 2019.  CMS will be releasing presentation slides within five (5) to seven (7) days and will also be releasing the audio recording thereafter.  Some of […]

CMS Announces Webinars for MSPRP and CRCP Electronic Payment Options

CMS will be hosting two webinars to review the addition of a new electronic payment option that will be added to the Medicare Secondary Recovery Portal (MSPRP) and the Commercial Repayment Portal (CRCP) effective April 1, 2019.  The webinars will include opening remarks followed by a presentation on the new electronic payment functionality. The MSPRP […]

Confusion, Conjecture and Clarification: The New WCMSA Reference Guide

With the issuance of updated Workers’ Compensation Medicare Set-Aside Reference Guide version 2.9 (Guide), there has some speculation and even confusion as to what is really new and what is an elaboration of old policies and procedures.  Examples listed for off-label drug usage to new bullets added regarding the submission process, all of which begs […]