Going Down The Rabbit Hole Post Settlement: What Can Medicare Do?

Going Down The Rabbit Hole Post Settlement: What Can Medicare Do?

By P. Czuprynski The Medicare Secondary Payer Act (MSP) identifies Medicare is supposed to be second in line for payment if there is a non-group health plan that covers a certain date of incident or claimed medical expenses (i.e. workers’ compensation, liability or...
Updated Section 111 NGHP Model Language

Updated Section 111 NGHP Model Language

By B. Smith CMS has released an updated Section 111 Model Language form to assist Responsible Reporting Entities (RREs) in obtaining critical information needed to determine claimants’ Medicare eligibility status.   A copy of this form can be found here.  This form...
Medicare Set-Aside Administration Questions and Answers

Medicare Set-Aside Administration Questions and Answers

Written by B. Smith The administration of a Medicare Set-Aside and the requirements for proper administration can sometimes be unclear and confusing.  Below is a list of frequently asked questions and answers to assist the parties in better understanding this process....
Downstream Actors May Have a Right to Reimbursement

Downstream Actors May Have a Right to Reimbursement

October 2, 2020 By Patrick Czuprynski Downstream Actors May Have a Right to Reimbursement: MSP Recovery Claims v. Ace Am. Ins. Co, 2020 U.S. Dist. Lexis 28610 In Ace, the U.S. Court of Appeals for Eleventh Circuit reversed a District Court’s decision and determined...
CMS Issues New Section 111 Alert

CMS Issues New Section 111 Alert

Jun 12, 2020 by Bridget Smith, JD CMS Issues New Section 111 Alert for Reporting No-Fault Insurance Limit on Non-Group Health Plan (NGHP) Claim Input Files In this Alert dated June 8, 2020, CMS  reminds Non-Group Health Plan (NGHP) Responsible Reporting Entities...