Why Conditional Payments Rarely Work Out the Way You Plan!

Ever wonder why it is so difficult to resolve Centers for Medicare and Medicaid Services (CMS) conditional payments for non-group health plans? We have some thoughts and tips that will help you better manage this Medicare Secondary Payer compliance risk. What is a conditional payment? ...
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MMSEA Section 111 Reporting Secrets You Never Knew

In the past, before MMSEA Section 111 reporting, CMS had no tracking method to identify injury/ accident claims involving Medicare beneficiaries. The only way this information could be gathered was through voluntary phone calls placed to the Benefits Coordination and Recovery Center, formerly known as ...
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Survey: Medicare Secondary Payer (MSP) Compliance Lacks Transparency and Control

Introduction This paper discusses the current state of Medicare secondary payer (MSP) compliance within the property and casualty (P&C) industry. Our payer survey findings show payers view MSP compliance as unmanaged and out of control. MSP compliance is excessively costly. The time has come for ...
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The Future of Medicare Set-Asides – NAMSAP Highlights

Leta Sharkey MS, NCC, CDMS, CRP, CLCP, MSCC Vice President, Care Bridge International What was on everyone’s mind at NAMSAP was HR 2649 and S 1514, Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act of 2015 which reportedly will be approved by December 7, ...
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What’s Next for Liability MSAs?

By Deborah (Pfeifle) Watkins, CEO On June 8, 2016 the Centers for Medicare and Medicaid Services (CMS) posted an announcement stating that CMS is considering expanding its voluntary Medicare Set-Aside Arrangement (MSA) review and approval process for proposed liability insurance, including self-insurance and no-fault. See ...
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When MSP Compliance Survey Results Send You Running For Cover

An Expert Interview about CMS NGHP Section 111 Reporting to Achieve Better Outcomes