Regarding Medicare Secondary Payer and Certain Civil Money Penalties By now you have heard about the October 11, 2023, Final Rule regarding Medicare Secondary Payer, and Certain Civil Money Penalties, in development since January 2013. CMS received 34 comments in response to the December 2013… Read More »Final Rule
Medicare Secondary Payer (MSP) Civil Money Penalties (CMP) Recent Medicare Secondary Payer Final Rule update draws attention to the importance of ensuring that Medicare Section 111 (SCHIP) Reporting is identifying all claims involving Medicare Beneficiaries are reported quarterly as required. Recently, the Office of management… Read More »Final Rule Update
Recently, a client asked, “If I submit a Medicare Set Aside (MSA) to the Centers for Medicare and Medicaid Services (CMS) for review and approval, will it be approved? True story: A few years ago, when the Workers Compensation Review Center (WCRC) was in Baltimore,… Read More »INSIDER SECRETS: CMS Review and Approval of MSAs
On May 16, 2023, CMS Announced its updated Version 3.9 of the Workers Compensation Medicare Set-Aside Arrangements (WCMSA) Reference Guide available to download at Workers’ Compensation Medicare Set Aside Arrangements. We bullet point the changes in this latest version as follows: In this section CMS… Read More »CMS Announces Updates to Medicare Secondary Payer Compliance in April/May 2023
There’s no denying it. Summer is in the air! The days and weeks ahead of family vacations, weekend getaways, or just enjoying a good book on a beach with the sound of lapping waves to keep you company are fast approaching. We have just one… Read More »Are YOUR CLAIMS Ready for Your Summer Break?
Last week, we spoke about the lack of transparency and compliance with Medicare Secondary Payer (MSP) in the Property & Casualty claims environment, and the reasons for that. Did you also know that despite all the “pats on the back” for underwriting profitability with… Read More »Your Workers Compensation Program Has a Claim Problem
Do your claim professionals recognize a claim involving a Medicare Beneficiary in 2022? Do they understand the full scope of Medicare’s regulatory requirements to consider at the time of settlement? Do your claim professionals recognize the monetary and reputational risk involved if they fail to… Read More »Are You at RISK of Medicare Secondary Payer NON-Compliance in 2022?
Last week was my first time stepping back on stage for over two years. This time it was with the Reuters team at Insurance AI and Innovative Tech USA 2022. Stepping back out from behind the camera and into the more traditional role of an… Read More »Reuters, AI & Analytics USA - Stepping into The (Un)known
As a data-driven company, we measure and watch the Centers for Medicare and Medicaid Services (CMS) Workers’ Compensation Review Center (WCRC) where workers compensation MSA (Medicare Set Aside) determinations are made. We compare each CMS determination against Care Bridge International’s proposed MSA for accuracy. A… Read More »BEWARE! Errors in the CMS MSA Review Process
YOU CAN BE fast and accurate! Calculating medical reserves is an important part of the workers compensation claims process, but it has historically been inaccurate and time-consuming. According to the American Society of Actuaries, in the past 4 decades, 100 insurance companies became insolvent mostly… Read More »Analytic-Powered Medical Reserve