Centers for Medicare and Medicaid Services News

Viewpoint: Third Parties Create a Medicare Headache for Insurers and Employers

Dealing with Medicare-related issues in a workers’ compensation claim has never been anyone’s idea of a “good time” from the employer and insurer’s perspective. From the challenges Medicare creates with settlement, to the uncertainty faced when submitting Medicare Set-Asides (MSAs) …

Montana Psych Hospital Loses Payments After Deaths, Assault

HELENA, Mont. (AP) — Federal officials say they’ll no longer pay for services at Montana’s state psychiatric hospital following staffing shortages and other problems that were blamed in patient deaths and a violent assault last month involving unsupervised patients. The …

Updated CMS Guide Spells Out the Risk of Skipping CMS Review of Work Comp Settlements

Insurers that are inclined to skip a government review of proposed workers’ compensation settlements may think twice about that strategy because of an updated policy guideline issued by the Centers for Medicare and Medicaid Services on Jan. 11. For the …

Viewpoint: CMS’ Liability Medicare Set Aside Proposal is Bad Policy

It’s a scenario every senior citizen fears—getting seriously injured in an accident. Whether it’s a slip and fall at the grocery store or getting hit by a car crossing the street, the question of “who pays?” often isn’t far from …

MSP Changes Include Penalties, Review Criteria, Double Damages: Viewpoint

As we approach the halfway point of 2019, Medicare Secondary Payer (MSP) continues to be one of the most rapidly evolving areas of compliance in claims. On the horizon are possible significant changes relating to each compliance point: Section 111, …

Viewpoint: What’s Hiding in Your Medical Records?

Every year, organizations pay out millions of dollars in settlements for workers’ compensation claims for services they often shouldn’t. I’m not talking about insurance fraud but rather an unseen problem that routinely balloons out of control. It is vital to …