Category Archives: Blog

Blog, Legal/Legislative News, Medicare Reporting Section 111, Medicare Secondary Payer News

As we had blogged about last October, the 9th Circuit in CIGA v. Azar held that CIGA as a Guaranty Fund was not a “primary plan” under the MSP, due to the fact that CIGA pays for medical care only if the insurer is insolvent, and as such the WC claim does not automatically trigger coverage. For our prior blog, …
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Blog, Franco Signor News, Legal/Legislative News, Medicare Reporting Section 111, Medicare Secondary Payer News

All attendees must register separately. You will receive the log-in/call-in information once you register. Click the link below to register for this webinar session to be held on Mar 26, 2020 1:30 PM EDT. https://attendee.gotowebinar.com/register/300143989975532034   Don’t miss this opportunity to hear from the experts! The Centers for Medicare & Medicaid Services (CMS) recently concluded its Proposed Rule on Civil …
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Blog, Franco Signor News, Legal/Legislative News, Medicare Conditional Payments, Medicare Jurisdiction, Medicare Reporting Section 111, Medicare Secondary Payer News, Medicare Set Aside

The Different Paths to Protect the Medicare Trust Fund Medicare for All, Continued Privatization of Medicare and Growth of MSP Enforcement Are All on the Table Efficiency and expansion of healthcare coverage is of paramount concern in the 2020 presidential election. The Medicare program has particularly been in the spotlight, as Medicare accounts for a significant portion of federal spending. …
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Blog, Legal/Legislative News, Medicare Advantage Part C

In a decision out of the Eleventh Circuit, MSPA Claims v. Kingsway Amigo, 2020 U.S. App. LEXIS 4554 (February 13, 2020), Plaintiff MSPA Claims (aka MSP Recovery LLC) was able to persuade the Court that the Medicare Secondary Payer (MSP) 3-year claims filing provision located at 42 USC § 1395y(b)(2)(B)(vi) does not preclude a Medicare Advantage Organization (MAO) from filing …
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Blog, Legal/Legislative News, Medicare Reporting Section 111, Medicare Secondary Payer News

As we had blogged on just last week, today CMS officially published its Proposed Rule on “Medicare Secondary Payer and Certain Civil Monetary Penalties.” The link to the published Proposed Rule in the Federal Register can be found here. Additionally, CMS’ Fact Sheet on the Proposed Rule can be found here. The deadline to offer public comments to the rule …
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Blog, Legal/Legislative News, Medicare Reporting Section 111, Medicare Secondary Payer News

Yesterday, we learned CMS intends to publish its proposed Civil Monetary Penalty (CMP) rules for Section 111 Medicare & Medicaid SCHIP Extension Act reporting on 2/18/2020.  The Notice of Proposed Rule Making (NPRM) is the first step toward implementing a final rule that will impose penalties of up to $1,000 per day, per claim against Non-Group Health Plans (NGHPs) for …
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Medicare Secondary Payer Track Announced for WCI 2020

11 Feb 2020 Jesse Hamby No Comments

About Franco Signor, Blog, Franco Signor News

We are proud to announce this year’s speakers for the Medicare Secondary Payer Track at #WCI360!  Click here to see the outstanding lineup.  Come and listen to industry leaders discuss managing the changing landscape of compliance.  Hear CMS talk about MSP rules & ask questions of the Commercial Repayment Center.   Register today at https://www.wci360.com/conference/register/.

CMS Updates NGHP Guide with 2020 MSP Recovery Thresholds

10 Feb 2020 Heather Sanderson No Comments

Blog, Medicare Conditional Payments, Medicare Secondary Payer News, Reimbursements

As of January 31, 2020, CMS updated its NGHP User Guide to version 5.8 to include the 2020 MSP Recovery Thresholds. The updated NGHP User Guide Version 5.8 can be found here. As we had blogged on in December, CMS issued an Alert that the MSP recovery threshold (where reporting and conditional payment reimbursement is not required) would be maintained …
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Blog, Medicare Conditional Payments, Medicare Reporting Section 111, Medicare Secondary Payer News, Medicare Set Aside

On Tuesday, January 14th, the Centers for Medicare & Medicaid Services (CMS) hosted a Town Hall to discuss common Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) Ongoing Responsibility for Medical (ORM) recovery topics. On the main portion of the call, the following was discussed by John Albert and Nicole Griffin on behalf of CMS (note that CMS stated that …
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Keeping Up with Conditional Payment Obligations

08 Jan 2020 Heather Sanderson No Comments

Blog, Medicare Conditional Payments

This article was originally published in the January 2020 issue of CLM Magazine. Keeping Up with Conditional Payment Obligations – Effective Strategies for Medicare Conditional Payment Recovery Cost Containment  Read the article from CLM Magazine or download the PDF.  

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