Blog
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Administrative Procedure Act: Medicare, Medicare Advantage and Prescription Plans Must Follow its Regulations
With Chevron Deference being overturned, stakeholders facing conditional payment demands or payment denials by Medicare have a better chance of success in challenging Medicare’s decision. Federal district court review of...
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Success Spotlight: Persistence in the Re-Review Process Results in Savings of 65K
by K. Kline Advancing customer interests through the effective use of the Centers for Medicare & Medicaid Services (CMS) re-review process continues to be an important part of IMPAXX’s Workers’...
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CMS NGHP Civil Money Penalties Webinar and Slide Release
by B. Smith Updated: 11/25/24 – CMS provided a link to updated slides (now including Q&A) from their September 12 webinar on the What’s New page of the Mandatory Insurer Reporting for NGHP section on CMS.gov. On October 17,...
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Testing Now Available for Upcoming Change to S111 Work Comp Reporting
Responsible Reporting Entities (RREs) can now test file layout changes for the upcoming change to S111 Workers’ Compensation reporting effective April 4, 2025. RREs should coordinate testing with their...
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CMS Updates ICD-10 and ICD-9 Valid Code Lists for 2025
The Centers for Medicare & Medicaid Services (CMS) published updated ICD-10 and ICD-9 valid and excluded liability and no-fault code lists for 2025 on October 21, 2024. Valid ICD-10...
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CMS Updates NGHP User Guide to Version 7.7
by F. Fairchok The Centers for Medicare & Medicaid Services (CMS) published an update to the Non-Group Health Plan (NGHP) Section 111 Reporting User Guide on October 7, 2024. The...
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MSPN Annual Conference Recap
By M. Heberling and D. Dietz The National MSP Network held their annual educational conference on September 25-27. This was an exciting year to be at the conference as there...
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CMS Launches New NGHP Civil Money Penalties Webpage
by B. Smith The Centers for Medicare and Medicaid Services (CMS) has launched a new webpage regarding Section 111 Civil Money Penalties (CMPs) for Non-Group Health Plans (NGHP). The webpage...
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CMS to Host Second Webinar on Certain Civil Money Penalties Final Rule for NGHP Responsible Reporting Entities
The Centers for Medicare & Medicaid Services (CMS) has announced they will be hosting their second Medicare Secondary Payer (MSP) and Certain Civil Money Penalties (CMPs) Informational Webinar on...