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Impact of Section 111 Reporting on Conditional Payment Resolution

Impact of Section 111 Reporting on Conditional Payment Resolution

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 […]

WCMSA 4.2 Update

January 2025

WCMSA 4.2 Update

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 […]

Updated NGHP User Guide Outlines New Warning Flag for Open ORM Claims

October 2024

Updated NGHP User Guide Outlines New Warning Flag for Open ORM Claims

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 […]

CMS Announces Updates to Section 111 COBSW Portal

August 2024

CMS Announces Updates to Section 111 COBSW Portal

Author: Logan Pry On August 8th, CMS issued an alert confirming that COBSW system updates are coming soon. The Section 111 Coordination of Benefits Secure Website (COBSW) provides general information on Section 111 reporting, links and instructions, reference materials including various user guides, as well as a secure portal which provides the ability to manage your […]

CMS Releases NGHP Section 111 User Guide Version 7.4

February 2024

CMS Releases NGHP Section 111 User Guide Version 7.4

Author: Logan Pry CMS has released its first version of the Non-Group Health Plan Section 111 Reporting User Guide of 2024. Not long after a recent informational webinar regarding Civil Monetary Penalties held on January 18, CMS released version 7.4 of the User Guide, in which the primary update is the addition of Ch. III, sect. […]

NGHP Section 111 Reporting CMS Webinar on Civil Monetary Penalties

January 2024

NGHP Section 111 Reporting CMS Webinar on Civil Monetary Penalties

Author: Ciara Koba CMS hosted a live webinar on January 18th at 1pm EST.  This webinar provided valuable information for responsible reporting entities (RREs) as the industry prepares for CMS to begin quarterly compliance audits and the imposition of civil monetary penalties.  Please find the highlights of the webinar below and if you have further questions about […]