Summary of Final Rule: Conditional Payment Appeals Process for Applicable Plans

On February 27, 2015, CMS published in the Federal Register the SMART Act Appeal Final Rule which can be located at 80 Fed. Reg. 10611. The rule can be found here and will go into effect on April 28, 2015. CMS had previously issued the Proposed Rule on this very topic on December 27, 2013. Materially, the … Read moreSummary of Final Rule: Conditional Payment Appeals Process for Applicable Plans

CMS to Extend Deadline for Reporting SSNs?

Pursuant to section 204 of the SMART Act, within 18 months of the enactment of the SMART Act (which is July 10, 2014), CMS was required to modify MMSEA Section 111 Reporting Requirements so that an RRE was no longer required to report social security numbers (SSNs) or health insurance  claim numbers (HICNs).  However, within … Read moreCMS to Extend Deadline for Reporting SSNs?

Government Shutdown and Impact to MSP and CMS

As of 2:30 P.M. EST this afternoon, the U.S. Senate has rejected the latest House “Continuing Resolution” needed to fund federal government operations beyond the end of the fiscal year, set to end tonight, September 30th at midnight.  Therefore, it appears very likely that the Government will shut down, at least for several days, starting tomorrow, October … Read moreGovernment Shutdown and Impact to MSP and CMS

The SMART Act Simplified: What do I need to know and how will it impact my claims handling?

The SMART Act reforms certain aspects of the MSP and the MMSEA. While the SMART Act does not directly broach how to protect Medicare’s interests with regard to any future medical component, it does directly reform components of the conditional payment reimbursement process and MIR under the MMSEA. Conditional payments are allowed under the MSP … Read moreThe SMART Act Simplified: What do I need to know and how will it impact my claims handling?

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