CMS
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CMS Issues New WCMSA Reference Guide Version 3.8
By B. Smith Yesterday, CMS released version 3.8 of their Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide, which now includes an additional Re-Review option when the parties wish to...
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CMS to Host Section 111 NGHP Reporting Webinar on Dec. 6
CMS will be hosting a Section 111 Non-Group Health Plan (NGHP) reporting webinar on Wednesday, December 6 at 2:00 pm ET. They will kick off the webinar with opening remarks...
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Medicare Set-Aside Statistics 2020-2022 Continue to Show Increase in Submitted MSA Amounts
by B. Smith This week, the Centers for Medicare & Medicaid Services (CMS) released the 2020-2022 fiscal year statistics for Workers’ Compensation Medicare Set-Asides (WCMSAs) that have been submitted to...
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CMS Now Consistently Requesting Expense Payment Histories
by J. Mislanovich The Centers for Medicare & Medicaid Services (CMS) WCMSA Reference Guide has always indicated that an all-inclusive payment history (including medical, indemnity, and expenses) is to be...
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CMS Withdraws Future Medicals Proposed Rule
by B. Smith The Office of Management and Budget (OMB) posted a notice on its website yesterday that the Centers for Medicare & Medicaid Services (CMS) has formally withdrawn the...
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CMS Publishes NGHP User Guide Version 6.9
by F. Fairchok CMS published an update to the NGHP User Guide on October 3, 2022. Version 6.9 announced changes to the areas of ICD coding and SP31 error code...
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Medicare Issues Group Health Plan (GHP) Defense Reference Guide
by P. Czuprynski Recently, Medicare issued a reference guide associated with conditional payment recovery related to group health plan claims. So, if a person has group health coverage AND Medicare...
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Eleventh Circuit Holds Section 111 Reporting Can Establish Elements of Private Cause of Action Under MSP Act
by B. Smith The Eleventh Circuit Court of Appeals in MSP Recovery Claims, Series LLC v. Metropolitan General Insurance Company, et. al., Case No. 21-11547 (11th Cir. July 18, 2022),...
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CMS Issues WCMSA Reference Guide Version 3.7
Recently, CMS issued Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide Version 3.7. CMS updated Section 10.3 with a new link to the CDC Life Table. IMPAXX shared the news that...