The Centers for Medicare & Medicaid Services (CMS) will be hosting an overview of the new “Go Paperless” feature available in the Medicare Secondary Payer Recovery Portal (MSPRP) on Thursday, April 13 at 1:00 pm ET. The webinar will feature opening remarks and a presentation, followed by a question and answer session. Insurers and authorized agents may now choose to opt-in to paperless functionality. Once registered for the paperless option, users will be able to access all recovery correspondence including demand letters, as well as submit correspondence through the MSPRP. Further details ..read more

by Frank Fairchok, Vice President of Medicare Reporting Services Last week, the Centers for Medicare & Medicaid Services (CMS) advanced the rulemaking process in two long-awaited areas. The Regulation Identifier Numbers for “Medicare Secondary Payer and Future Medicals” (0938-AT85) and “Medicare Secondary Payer and Certain Civil Money Penalties” (0938-AT86) were advanced to the Office of Management and Budget (OMB) for review of the final rule. 0938-AT85 – Medicare Secondary Payer and Future Medicals (CMS-6047) The latest abstract for this rule states: “This proposed rule would clarify exi ..read more

The Centers for Medicare & Medicaid Services (CMS) recently announced that Non-Group Health Plan (NGHP) and Group Health Plan (GHP) Medicare Secondary Payer (MSP) recovery debts may be paid using Automated Clearing House (ACH) transactions, offering more convenience and efficiency by allowing payers to utilize their own existing software and accounts payable processes to submit payments electronically. With this new option, the debtor’s bank will submit a payment through the ACH Network. Funds will then be sent by electronic funds transfer (EFT) to the Commercial Repayment Center (CRC) or ..read more

The Centers for Medicare & Medicaid Services (CMS) announced yesterday that it will be hosting a Workers’ Compensation Medicare Set-Aside (WCMSA) webinar next Thursday, February 17, 2022 at 1:00 pm ET. The webinar will include a variety of WCMSA topics, including a summary of what’s new in Medicare set-asides, and address questions related to the inclusion of treatments, application of state rules, re-reviews/amended reviews and more. The presentation will be followed by a live question and answer session with representatives from CMS. Due to the large number of participants expected, CMS ..read more

Earlier this month, CMS issued Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide Version 3.5. The guide includes a new section, The Use of Non-CMS-Approved Products to Address Future Medical Care (Section 4.3), which states: “A number of industry products exist with the intent of indemnifying insurance carriers and CMS beneficiaries against future recovery for conditional payments made by CMS for settled injuries. Although not inclusive of all products covered under this section, these products are most commonly termed “evidence-based” or “non-submit.” 42 C.F.R. 411 ..read more

MEDVAL is pleased to be attending and exhibiting at the 75th Annual Workers Compensation Educational Conference December 12-15, 2021, at the Orlando World Center Marriott. With 3000 attendees expected, we look forward to connecting with clients, partners and prospective customers.  If you are planning to attend, please stop by and visit us at Booth 911. The PAID Act goes into effect on December 11, 2021. At the conference we will be highlighting our new Medicare Part C and D Recovery program and providing tips on how to prepare for this significant change. You don’t want to miss it! For m ..read more

by Frank Fairchok, Vice President of Medicare Reporting Services The Centers for Medicare & Medicaid Services (CMS) published an update to the NGHP User Guide on January 10, 2022, which introduces a paperless option for Responsible Reporting Entities (RREs) and their Recovery Agents to receive recovery correspondence. The summary of updates to User Guide Version 6.7 states: “When there is an active Medicare Secondary Payer Recovery Portal (MSPRP) account for the insurer/recovery agent TIN, Section 111 submitters may set Go Paperless options (i.e., choose to receive letters electronically o ..read more

by Charlotte Chovanec, RN, BSN, MHA, Clinical Director & Leah King, PharmD, JD, Independent Pharmacy Consultant Recently, the price of omeprazole, a generic version of Prilosec, decreased rather significantly. History of Prilosec (Omeprazole)Prilosec, the first proton pump inhibitor approved by the FDA in 1989, has been widely utilized for more than three decades to treat a variety of gastrointestinal conditions such as heartburn, acid reflux and gastric ulcers. In the early 2000’s, the Federal Drug Administration (FDA) approved the first generic versions of Prilosec and approved over the ..read more

by Frank Fairchok, Vice President of Medicare Reporting Services In what continues to be an exciting time of change in the Medicare Secondary Payer space, CMS released version 6.5 of the NGHP User Guide last week (dated 10/4/21). This new version provides additional updates around the evolving query processes in relation to the implementation of the PAID Act. While this article will cover those changes in-depth, we start with a summary of other changes highlighted, some of which are substantial. Direct Data Entry (DDE)Responsible Reporting Entities (RREs) that utilize the Direct Data Entry (DD ..read more

CMS recently published a copy of the slides from their September 9 webinar presentation, Provide Accurate Information Directly (PAID) Act Testing, to the What’s New page on CMS.gov. For more detailed information and highlights from the webinar, read our recent blog Key Takeaways from CMS’ PAID Act Testing Webinar. The post Slides Available – CMS’ PAID Act Testing Webinar appeared first on Medval ..read more