Major Changes to Conditional Payment Reimbursement Process for Entities that Have Accepted ORM

As those of you who follow us regularly on this blog know, on August 5, 2015, we anticipated that after the Center for Medicare and Medicaid Services (CMS)’ announcement of the transition to the Commercial Repayment  Center (CRC) for reimbursement of conditional payments (CP) directly from applicable plans (AP) who have accepted ongoing responsibility for … Read moreMajor Changes to Conditional Payment Reimbursement Process for Entities that Have Accepted ORM

NGHP User Guide 4.7 Released on July 13, 2015

CMS has released an updated User Guide with version number 4.7 on July 13, 2015. This update appears to incorporate alerts previously released only. CMS provides the summary of updates, along with the User Guide chapters impacted, as follows: Change Request 32: Accept and process Recovery Agent information on Section 111 NGHP TIN Reference File … Read moreNGHP User Guide 4.7 Released on July 13, 2015

CMS Releases Updated NGHP User Guide Version 4.4

CMS has released an updated User Guide for NGHPs, version 4.4, on January 5, 2015. The updates contained in the new version appear to have been previously released on alerts. While these edits are bringing the User Guide up-to-date with the alerts, Helios encourages RREs and claim administrators to review the new User Guide in its entirety to ensure compliance. … Read moreCMS Releases Updated NGHP User Guide Version 4.4

CMS Issues Liability Insurance Settlement Reporting and Recovery Threshold Pursuant to SMART Act

On February 18, 2014, CMS issued an alert notifying the industry of a threshold in which liability settlements would no longer need to be reported to CMS under MMSEA Section 111 and also would not require conditional payment reimbursement under the MSP.  A copy of the alert can be found here.   In the alert, CMS … Read moreCMS Issues Liability Insurance Settlement Reporting and Recovery Threshold Pursuant to SMART Act

%d bloggers like this: