The Centers for Medicare and Medicaid Services (CMS) has published a Frequently Asked Questions (FAQ) document to supplement its recently released Section 111 penalties rule. There were a few crucial clarifications that we highlight below.Start Date for Reporting Data Subject …
Federal rules that impose $1,325-per-day civil money penalties on insurers and other organizations that fail to report settlements or judgments that require payment for a Medicare beneficiary’s medical care will take effect on Oct. 11, 2024. The final version of …
Dealing with Medicare-related issues in a workers’ compensation claim has never been anyone’s idea of a “good time” from the employer and insurer’s perspective. From the challenges Medicare creates with settlement, to the uncertainty faced when submitting Medicare Set-Asides (MSAs) …
For years, the federal agency that runs Medicare has been building a trap to snag any settlements that would force taxpayers to pick up the for tab for medical care that should have been paid by others. The Centers for …
Insurers that are inclined to skip a government review of proposed workers’ compensation settlements may think twice about that strategy because of an updated policy guideline issued by the Centers for Medicare and Medicaid Services on Jan. 11. For the …
It’s a scenario every senior citizen fears—getting seriously injured in an accident. Whether it’s a slip and fall at the grocery store or getting hit by a car crossing the street, the question of “who pays?” often isn’t far from …
Ask claims adjusters what they think of Medicare Set-Asides (MSAs) and you’ll likely get a wide range of answers. While most would agree, in theory, that MSAs serve a valid purpose, the way they are constructed today is labor-intensive, slow, …
As we approach the halfway point of 2019, Medicare Secondary Payer (MSP) continues to be one of the most rapidly evolving areas of compliance in claims. On the horizon are possible significant changes relating to each compliance point: Section 111, …
Every year, organizations pay out millions of dollars in settlements for workers’ compensation claims for services they often shouldn’t. I’m not talking about insurance fraud but rather an unseen problem that routinely balloons out of control. It is vital to …
Since Medicare released the July 23, 2001 “Patel” memorandum concerning workers’ compensation and many subsequent memoranda, there have been numerous guidelines for the evaluation and submission of Medicare set asides (MSA). We are all aware of the review thresholds: Medicare …