CMS Alerts

Commercial Repayment Center (CRC) Outreach Program: Getting to know your CRC Operator

Commercial Repayment Center (CRC) Outreach Program: Getting to know your CRC Operator NuQuest recently met with the operator of CRC, Performant Financial Corporation, as a part of their stakeholder outreach program.  Performant Financial Corporation began operating CRC in February of 2018. More about this can be found here. At the meeting, CRC provided a presentation […]

Now Available – CMS Electronic Payment Enhancement Overview

CMS has now posted the Electronic Payment Enhancement Overview Webinar presentations which were held on March 13, 2019, for NGHP and March 14, 2019, for GHP.  The presentations can be found in the Downloads section of the Coordination of Benefits & Recovery Overview What’s New page on CMS.gov.

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 […]

a medical device over hundred dollar bills

CMS Issues a Revised WCMSA Reference Guide and Section 111 User Guide

The Centers for Medicare and Medicaid Services issued a revised WCMSA Reference Guide (Reference Guide), Version 2.9, which can be found here: WCMSA Reference Guide.  In addition to changes to development and alert templates; references to removal of certain memorandum from cms.gov; and reference to the updated CDC Life Table, the Reference Guide also includes updates […]

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CMS and Medicaid to Convert to CDC 2015 Life Table

The Centers for Medicare and Medicaid Services has announced that it will convert to the CDC’s “Table 1: Life Table for the total population: United States, 2015“ for Workers’ Compensation Medicare Set-Aside life expectancy calculations.  The change to the updated life table will become effective as of January 5, 2019.  There is a slight increase […]

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The OMB Issues Intent of Notice of Proposed Rule Making for Section 111 Penalties

In an abstract entitled “Civil Money Penalties and Medicare Secondary Payer Reporting Requirements,” the Office of Management and Budget has issued another intent of Notice of Proposed Rulemaking this time involving Section 111 Reporting penalties.  Specifically, the abstract of the Notice provides as follows: Section 516 of the Medicare Access and CHIP Reauthorization Act of […]

a medical device over hundred dollar bills

Office of Management and Budget Issues Proposed Rulemaking Regarding MSP Compliance Options

Under the title “ Miscellaneous Medicare Secondary Payer Clarifications and Updates,” the Office of Management and Budget issued proposed rulemaking to address Medicare Secondary Payer obligations in the context of automobile and liability insurance, no-fault insurance and workers’ compensation recovery.  The abstract of the proposed rule states as follows: “This proposed rule would ensure that […]

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Success in the CMS Re-Review Process

Pursuant to Section 16.0 of the Workers’ Compensation Medicare Set Aside (WCMSA) Reference Guide, Version 2.8, October 1, 2018, COBR-Q4-2018-v2.8, CMS will conduct a Re-Review of a prior WCMSA determination in certain circumstances.  Specifically, CMS will complete this process in cases involving a mistake in the allocation; mathematical error; or when there is missing documentation […]

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Settlement reporting threshold of $750 remains for 2019 and Enhancements to the Medicare Secondary Payer Recovery Portal (MSPRP) Coming 1/7/2019.

On 11/15/2018, Medicare issued its annual recovery threshold calculation. This threshold determines the amount of settlement, judgement or award that must be reported to Medicare under the Section 111 reporting rules. For 2019, any settlement, judgement, award at or above $750.00 should be reported to Medicare through Section 111 reporting.  Medicare’s announcement can be found […]