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CMS Alert: Conditional Payment Debt Referral to Treasury Department
CMS issued an alert August 5, 2015 regarding a change in the timeframe in which outstanding conditional payment debts are referred to the...
Melisa Zwilling
Aug 6, 2015
Upcoming Conferences
We hope to see you this summer at: Alabama Self-Insurer's Association Summer Conference August 9-11, 2015 at Hilton Sandestin Resort Come...
Melisa Zwilling
Aug 6, 2015
Delaware Superior Court: MAOs Importance in the Medicare System
In Honey v. Bayhealth Medical Center, Inc., 2015 Del. Super. LEXIS 378, a Superior Court in Delaware recently bolstered the importance...
Melisa Zwilling
Aug 6, 2015
CMS Update: Webinar Annoucement
CMS posted a webinar announcement today concerning the transition of NGHP recovery activities to The Commercial Repayment Center (CRC)....
Melisa Zwilling
Aug 3, 2015
US District Court: Contractual Obligation Does Not Demonstrate Primary Payer Responsibility
In MSPA Claims 1, LLC v. Liberty Mut. Ins., No. 1:15-cv-21417-UU, 2015 U.S. Dist. LEXIS 99188 (S.D. Fla. July 22, 2015), an individual...
Melisa Zwilling
Aug 2, 2015
Case Study: Are Unnecessarily High MSAs Driving your Settlements Out of Range?
Quite often we are asked to provide second-opinion review of MSA allocations that were prepared by another vendor. We have consistently...
Melisa Zwilling
Jul 21, 2015
CMS Update: Section 111 NGHP User Guide
On July 13, 2015, CMS issued an updated Section 111 NGHP User Guide. In an effort to prevent false positives in partial SSN searches, CMS...
Melisa Zwilling
Jul 17, 2015
CMS Alert: ICD-10 Reporting Reminder
CMS issued an alert as a reminder that Responsible Reporting Entities and their agents must report ICD-10-CM diagnosis codes on claim...
Melisa Zwilling
Jul 17, 2015
Melisa Zwilling Set to Speak at National Conference in November
Melisa C. Zwilling will be presenting at the 24th Annual National Workers' Compensation and Disability Conference® in Las Vegas, November...
Melisa Zwilling
Jul 16, 2015
Eleventh District Court Dismisses MAO Private Cause of Action
Medicare Advantage Organizations (MAOs) right to recovery under the private cause of action provision of the Medicare Secondary Payer Act...
Melisa Zwilling
Jul 9, 2015
CMS Announces Transition of NGHP recovery to Commercial Repayment Center
Currently, Medicare's Benefits Coordination and Recovery Center (BCRC) handles the recovery of conditional payment claims in workers'...
Melisa Zwilling
Jul 8, 2015
Section 111: Rule on Penalties Not Expected Until December 2016
Under the SMART Act, CMS is supposed to issues rules specifying "practices for which sanctions will and will not be imposed." In...
Melisa Zwilling
Jun 24, 2015
IMRs in California Accepted by CMS in Carr Allison MSA Allocations
Under California workers' compensation law, as of July 1, 2013, medical treatment disputes for all dates of injury are resolved through...
Melisa Zwilling
Jun 19, 2015
CMS Alert: Matching Criteria for SSNs
On June 18, 2015, CMS issued an Alert entitled "Modification of Matching Criteria Used When Reporting Partial Social Security Numbers for...
Melisa Zwilling
Jun 18, 2015
Michigan Court of Appeals Allows Plaintiff to Pursue Private Cause of Action against No-Fault Insure
In Holmes v. Farm Bureau Gen. Ins. Co., No. 320723, 2014 Mich. App. LEXIS 1031 (Mich. Ct. App. May 19, 2015), Holmes was injured in a...
Melisa Zwilling
May 28, 2015
Summary: CMS Applicable Plan Appeals Webinar
In case you missed the webinar on May 5, 2015, we have provided a summary of the webinar below: CMS held a webinar to discuss the new...
Melisa Zwilling
May 12, 2015
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