The US 9th Circuit Court of Appeals has ruled that The Centers for Medicare and Medicaid [CMS] cannot not seek reimbursement from from the California Insurance Guarantee Association for workers' compensation payments.
Showing posts with label Medicare Secondary Payer. Show all posts
Showing posts with label Medicare Secondary Payer. Show all posts
Friday, October 11, 2019
Monday, September 10, 2018
CMS has scheduled another webinar for Wed., Sept 19, 2018
Commercial Repayment Center Portal (CRCP) Overview Webinar Wednesday, September 19 th, 2018 CMS will be hosting a webinar to present an overview of the Commercial Repayment Center Portal (CRCP) functions.
Monday, January 6, 2014
CMS Takes a New Direction in the Proposed MSP Appeal Process
The Centers for Medicare and Medicaid services (CMS) has proposed rules for the Medicare Secondary Payer (MSP) appeals process that will target the “applicable plan” as the primary responsible party for recovery.
Medicare, in pursuing recovery directly from the applicable plan, removes the beneficiary, as well as the provider or supplier, as the responsible party to initial a re-determination and all subsequent levels of the administrative process that could culminate in judicial review.
Docket ID:CMS-2013-0270
Topic(s):Administrative Practices and Procedures, Health Facilities, Health Professions, Kidney Diseases, Medical Devices, Medicare, Reporting and Recordkeeping Requirements, Rural Areas, X-Rays
Document Type:Proposed Rule
Received Date:Dec 27, 2013
Start-End Page:78802 - 78807
Comment Start Date:Dec 27, 2013
Comment Due Date:Feb 25, 2014
Sunday, January 5, 2014
Comments Medicare Program: Obtaining Final Medicare Secondary Payer Conditional Payment Amounts via Web Portal
Comments submitted concerning the Medicare Program: Obtaining Final Medicare Secondary Payer Conditional Payment Amounts via Web Portal are now available for review.
Summary
This interim final rule with comment period specifies the process and timeline for expanding CMS' existing Medicare Secondary Payer (MSP) Web portal to conform to section 201 of the Medicare IVIG and Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act). The interim final rule specifies a timeline for developing a multifactor authentication solution to securely permit authorized users other than the beneficiary to access CMS' MSP conditional payment amounts and claims detail information via the MSP Web portal. It also requires that we add functionality to the existing MSP Web portal that permits users to: notify us that the specified case is approaching settlement; obtain time and date stamped final conditional payment summary forms and amounts before reaching settlement; and ensure that relatedness disputes and any other discrepancies are addressed within 11 business days of receipt of dispute documentation.
Docket ID:CMS-2013-0199
Topic(s):Kidney Diseases, Medicare, Physician Referral, Reporting and Recordkeeping Requirements
Document Type:Rule
Received Date:Sep 20, 2013
Start-End Page:57800 - 57806
Comment Start Date:Sep 20, 2013
Comment Due Date:Nov 19, 2013
Comments submitted included those of:
-Progressive Medical
-AAJ
-Property Casualty Insurers of America
-Crowe Paradis
-Franco Signor
-MARC
-CA State Compensation Fund
-NAMSAP
-DRI
-Allsup
-RIMS
-FCC
-Garretson Resolution Group
-AIA
-UWC
Thursday, August 22, 2013
US Supreme Court Asked to Review MSP Preemption Issue
The US Supreme Court has been asked to review a claim on behalf of an injured worker who asserts that the Medicare Secondary Payer Act did not preempt State law (i.e.. Texas) that required a Workers' Compensation claimant to obtain preauthorization from relevant insurance carriers before incurring certain medical expenses. The Fifth Circuit Court of Appeals held that Medicare's conditional payment for a workers surgeries did not render the state law mandate for preauthorization requirements "moot."
A Writ of Certiorari was filed with the US Supreme Court on Aug. 8, 2012 and a response is due September 11, 2013
Guadalupe Caldera v. Insurance Company of the State of Pennsylvania, US Supreme Court Docket No. 12-40192. Case below, 716 F 3d 861, Docket No, 12-40192, 5th Cir Ct Appeals, Decided May 14, 2013.
….
Jon L.Gelman of Wayne NJ is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson). For over 4 decades the Law Offices of Jon L Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.
Friday, January 11, 2013
Obama signs MSP Medicare bill
"The legislation changes the way Medicare collects money from people whose negligence caused a patient to incur medical bills. Murphy said the new law will streamline an outdated process, making it easier to close cases and bring money into the Medicare program."
Read more: http://thehill.com/blogs/healthwatch/medicare/276621-obama-signs-medicare-bill#ixzz2HehBHham
Questions remain on the practicalities of implementation as regulations need to be promulgated.
The NEW law will be discussed at the Hot Topics in Workers' Compensation Law 2013 Seminar (NJ ICLE Jn 29, 2013)
Read more: http://thehill.com/blogs/healthwatch/medicare/276621-obama-signs-medicare-bill#ixzz2HehBHham
Questions remain on the practicalities of implementation as regulations need to be promulgated.
The NEW law will be discussed at the Hot Topics in Workers' Compensation Law 2013 Seminar (NJ ICLE Jn 29, 2013)
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