Tag Archives: Medicare

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New WCMSA Reference Guide

CMS has issued an updated Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide, Version 3.4. The Guide has several minor changes including CMS’s focus on the receipt of appropriate settlement documents for the approval of the WCMSA.  Specifically, in Section 10.5 and in various sample letters in Appendix 5, CMS notes that “approval of the […]

Section 111 PAID Act Updates

On September 9, 2021, CMS hosted another webinar to discuss upcoming changes to the Section 111 query process.  These changes are being made to comply with the provisions of the PAID Act which requires CMS to provide enrollment information for Medicare Part C and Part D plans.  The following are some of the key highlights […]

CMS to Host PAID Act Webinar

On September 9, 2021,  CMS will be hosting a Provide Accurate Information Directly (PAID) Act testing webinar.  Webinar details can be found here. Should you have any questions regarding the PAID Act and the impact it will have on the Section 111 query process, please contact the NuQuest Settlement Consultants at: [email protected]  

CMS Releases PAID Act Presentation

The presentation from the June 23, 2021 PAID Act Webinar is now available in the download section of the NGHP What’s New page.  A link to the presentation can be found here.   Please see our prior blog by clicking here with a summary of the presentation highlights.  If you have any question regarding Section 111 […]

CMS Issues New Section 111 NGHP User Guide and PAID Act Technical Alert

CMS has been very busy this month.  In addition to the webinar scheduled for June 23, 2021 to discuss the Provide Accurate Information Directly (PAID) Act.  CMS has now issued a new NGHP User Guide and a PAID Act technical Alert.  The User Guide and the Alert contain significant substantive and technical changes regarding ORM […]

Going Down the Rabbit Hole Post Settlement: What Can Medicare Do?

By P. Czuprynski The Medicare Secondary Payer Act (MSP) identifies Medicare is supposed to be second in line for payment if there is a non-group health plan that covers a certain date of incident or claimed medical expenses (i.e. workers’ compensation, liability or no-fault claim). What this means is if Medicare made payment, but the […]

CMS Releases Updated WCMSA Reference Guide 3.3

CMS has released a new version of the Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide, 3.3, COBR-Q2-2021-v3.3 dated April 19, 2021. The new Guide includes additional language regarding the calculation of the seed money for structured settlements. When a structured WCMSA is utilized by the parties, in addition to annual payments, a calculation of the […]

CMS BCRC and CRC NGHP Town Hall Updates

On April 1, 2021, CMS held its scheduled Town Hall with the Benefits Coordination & Recovery (BCRC) and Commercial Repayment Center (CRC) for Non-Group Health Plans (NGHP).  Although parts of the Town Hall included information that was already disseminated by CMS in the past, there were some specific highlights as noted below. Partial Resolution of […]

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The PAID Act Becomes Law

The Provide Accurate Information Directly (PAID) Act, has been passed by the U.S. Congress and was signed by President Trump on December 11, 2020.   The purpose of the PAID Act is to address the lack of a centralized process to identify Medicare Advantage Plan and Medicare Part D Prescription Drug Plan beneficiaries.  Currently, the Section […]