Blog
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CMS Updates NGHP User Guide & NGHP Applicable Plan Appeals Guide
by F. Fairchok The Centers for Medicare & Medicaid Services (CMS) published updates to both the Non-Group Health Plan (NGHP) Section 111 Reporting User Guide and the Non-Group Health Plan...
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Success Spotlight: 96% Success Rate on Zero MSA Submissions
The Centers for Medicare & Medicaid Services (CMS) has no official policy when it comes to approval of a zero Medicare Set-Aside (MSA) waiver. Does CMS base approvals on...
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Success Spotlight: MSA Reduced by Over $600K Through Re-Review Process
At IMPAXX we advocate for our customers, which sometimes includes setting the record straight when the Centers for Medicare & Medicaid Services (CMS) includes treatments or medications in a...
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CMS Announces COB&R Outages for Last Weekend in June
Due to system modernization efforts, there will be outages to the following Coordination of Benefits & Recovery (COB&R) applications and operations during the last weekend in June. Normal operations...
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Conditional Payment Case Update: Angelo Et Al v. State Farm Mutual Automobile Insurance Company Et Al
by P. Czuprynski In Angelo et al v. State Farm Mutual Automobile Insurance Company et al, No.2:19cv12165, U.S. Dist. E.D. Mich. Southern Div. (3/26/2024), the Federal District Court in Michigan...
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What to Know About Section 111 Audits
by B. Smith Section 111 audits are an important cost-containment measure to prevent potential Civil Money Penalties (CMPs) and conditional payment exposure. However, the thought of an audit can be...
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CMS Releases Updated Self-Administration Toolkit Version 1.5
by J. Shymanski While dated May 15, 2024, the Centers for Medicare & Medicaid Services (CMS) released version 1.5 of the Self-Administration Toolkit for Workers’ Compensation Medicare Set-Aside Arrangements (WCMSAs)...
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Medicare Provides Forms to Close CRC and BCRC Cases
by P. Czuprynski On May 13, 2024, Medicare issued two new forms that can be used to request that Medicare close a Commercial Repayment Center (CRC) or Benefits Coordination &...
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Is CMS Still Approving Zero-Waiver MSAs?
by D. Dietz Yes, the Centers for Medicare and Medicaid Services (CMS) is still approving Zero-Waiver Medicare Set-Asides (MSAs) on a case-by-case basis. Approval is based on documentation provided to...