Cases & Points Blog

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 […]

Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) Applicable Plan Recovery Webinar: Appeals

CMS will be hosting a CRC NGHP Applicable Plan webinar to review the procedures and best practices for redeterminations. The format will be opening remarks by CMS followed by a presentation from the CRC. This webinar will primarily focus upon how to effectively submit a redetermination request (sometimes called a first level appeal). During the […]

CMS Provides Webinar: Section 111 Non-Group Health Plan (NGHP)

August 17, 2020 by Patrick Czuprynski  On 8/13/2020, CMS provided a webinar and PowerPoint presentation to highlight and refresh stakeholders regarding certain aspects of Section 111 reporting and the recommendations outlined in the MMSEA Section 111 User Guide. It is important to understand that CMS is using the carrier/self-insured (or their TPA) claims system reporting […]

Barbara Fairchild awarded National Programs and Services Division Office MVP

We wanted to share the exciting news! What an accomplishment! 

Section 111 Non-Group Health Plan (NGHP) Reporting Webinar – Thursday, August 13, 2020

On Thursday, August 13, 2020, CMS will be hosting a webinar for Non-Group Health Plan (NGHP) Liability Insurance (including Self-Insurance) No-Fault and Workers’ Compensation Section 111 Reporting entities.  CMS will provide initial opening remarks followed by a presentation which will include best practice and reminders.  Questions for the webinar can be mailed to: Section 111 […]

CMS issues updated Non-Group Health Plan (NGHP) User Guide regarding Section 111 Reporting, Version 5.9

July 6, 2020 by Patrick Czuprynski, JD, MSCC, CMSP On 6/29/2020, Medicare issued an update to its NGHP User Guide. The following is a summary of those updates: Chapter III: Policy Guidance Sections 6.4.2, 6.4.3 and 6.4.4 were updated to remind Responsible Reporting Entities(RRE) that the $750 settlement reporting threshold does not apply to liability […]

Updated Time Frame for Future Medical Proposed Rule Making

Pursuant to the notification issued on the Office of Information and Regulatory Affairs OMBt website, the proposed rule to address future medicals in liability, no-fault and workers’ compensation cases has been pushed for release to August 2020. The proposed rule entitled Miscellaneous Medicare Secondary Payer Clarification and Updates (CMS-64047) was originally scheduled for release 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 […]