Our Insights

CMS opened 2023 with a series of updates to the NGHP Section 111 User Guide. First, on January 9, a new version of the User Guide – version 7.0 – was published. While several of the updates contained in this new iteration were informative only, including confirmation that the $750 settlement threshold will stay the […]

As what remains of 2022 dwindles into a new year, trending on the Medicare Conditional Payment front garners attention from industry stakeholders. Mounting concerns surrounding Civil Monetary Penalties associated with Section 111 Medicare Mandatory Insurer reporting (rulemaking anticipated by or before February 2023) could increase vigilance and reporting efforts. Additionally,  a recent OIG audit, which […]

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 re-review requests would be provided […]

Following the release of the updated Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide, Version 3.5, dated January 10, 2022, we have been waiting for CMS to announce a webinar to discuss the clarification on use of non-CMS approved products to address future medical care that this updated guide contained.  According to the Webinar Announcement […]

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 […]

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 […]