Our Insights

Author: Michelle Allan, Principal   In the dynamic world of governmental oversight, managing risks and reducing errors are crucial for ensuring compliance. Recently, these risks have become more pronounced in the Medicare Secondary Payer arena due to increased governmental scrutiny and new legal enforcement measures. Even minor typographical errors can lead to penalties and other […]

Author: Mesha Thompson, Conditional Payment Compliance Manager With all of the recent changes, updates, and alerts coming from CMS, it is important to remember that various aspects of MSP compliance directly impact one another. Namely, Section 111 reporting and conditional payment appeals. This past week, AKCS was tasked with resolving a lien in excess of […]

Author: Jeremy Papp, Esq. The Centers for Medicare & Medicaid Services (CMS) has released the latest version of the WCMSA Reference Guide. Effective July 17, 2025, CMS will no longer accept or review WCMSA proposals with a zero-dollar ($0) allocation. Entities must now consider specific parameters to determine if a $0 WCMSA allocation is appropriate […]

Author: Logan Pry On October 7th, CMS released Version 7.7 of the MMSEA NGHP User Guide with a few key updates. This iteration adds additional information regarding the steps needed and the emails that are issued during RRE registration, specifically Ch. 1 Table 7-1, Ch. 2 Table 6-4, and Ch. 4 Table 12-1. In general, these […]

Author: Carolyn McKaige Commencing October 2, 2023, the new maximum settlement amount for the Fixed Percentage Option (FPO) will be $10,000. This is double the current maximum settlement amount for the FPO of $5,000. The function of a FPO in Medicare conditional payments cases is that it streamlines the process for handling monies owed to Medicare. […]

Author: Ciara F. Koba, Esq., CMSP On November 14, 2022, CMS released version 3.8 of the WCMSA Reference Guide. If you attended the Medicare Secondary Payer Network 2022 Annual Conference (The National Medicare Secondary Payer Network) in September, you may have been anxiously anticipating the release of this updated guide with the hope that clarification on […]