CMS Alert! CMS to Host Workers' Compensation Medicare Set-Aside Webinar

CMS published an Alert indicating it will be hosting a webinar to discuss a variety of WCMSA topics, including a summary of what's new in Medicare set-asides, and addressing questions related to the inclusion of treatments, application of state rules, re-reviews/amended reviews and more.
Read more

CMS Launches 'Go Paperless' Option for MSPRP Account Holders

CMS will now provide RREs, as well as their Recovery Agents, with the option to go paperless with respect to Medicare recovery correspondence. In an updated NGHP Section 111 User Guide release, version 6.7, CMS states that insurers and their recovery agents may elect to receive electronic correspondence so long as a Medicare Secondary Payer Portal (MSPRP) account has been set up.
Read more

CMS Discredits Non-Submits in WCMSA Reference Guide Version 3.5

Whether or not to submit has through the years been touted as the main event at dozens of national conferences and seminars, promoting these sessions like MSP cage-match battles, pitting experts against one another in impassioned debate. Today Medicare put to rest more than a decade of MSP industry contention regarding whether Workers’ Compensation Medicare Set-Asides meeting Medicare’s published review thresholds must be reviewed and approved to establish validity and afford protection to Beneficiaries’ future Medicare entitlements. The decision is in and the answer is yes.
Read more

2022: LMSA Pushed to February, $750 Threshold Remains

It’s beginning to look a lot like LMSA rules aren’t happening in 2021. So if this was your wish from Santa, you must be on The Naughty List. This week, the Office of Information and Regulatory Affairs (OIRA) updated the timeframe from October 2021 to February of 2022. And for all of the “Nice” primary payers, beneficiaries, attorneys and insurance professionals, CMS kept its $750 minimum recovery threshold in place for the coming year.
Read more

Section 111 Reporting Update

Over recent weeks, CMS has posted a duo of alerts to the Non-Group Health Plan Mandatory Insurer Reporting landing page. While these alerts do not place any new obligations or requirements on Responsible Reporting Entities, they do provide some helpful reminders, coupled with a bit of guidance.
Read more

PAID Updates Added to Companion Guide Version 5.7

CMS has published an updated Benefits Coordination & Recovery Center (BCRC) 270/271 Health Care Eligibility Benefit Inquiry and Response Companion Guide for Mandatory Reporting Non-GHP Entities Version 5.7.
Read more

Contact Us

64 Danbury Road
Suite 201
CT 06897

Tel: +1 267 857 0544

For more information please email

To refer a file please email