Synergy’s blog brings you the industry’s foremost thought leadership InSights on matters of healthcare lien resolution and Medicare Secondary Payer Compliance. Visit often to discover helpful InSights on important lien resolution compliance issues.
With Medicare Secondary Payer (“MSP”) Compliance on everyone’s minds these days, it is no wonder that MSP vendors have tried to capitalize on these fears by offering services targeting them. The problem is that some of these vendors may be doing more harm than good.
The MSPRC announced a new option to self calculate a conditional payment amount to submit for approval if the settlement is $25,000 or less.
Some individuals are dual eligible. In plain English, this means they qualify for both Medicaid and Medicare. In certain cases, a Medicare Set Aside/Pooled Trust Sub-Account may be necessary to preserve the dual eligibility.
On June 27th, Medicare formally resumed issuing demand letters after it halted issuance in response apparently to the Haro v. Sebelius decision. I will summarize what is new in the demand letter.
The hiring of a Medicare Set Aside (“MSA”) allocation vendor is an important decision when settling a worker’s compensation or liability matter. The future medical costs included in the allocation report can make or break a case.
CMS has revamped the Medicare recovery process, creating a more efficient and less questionable path for the verification of Medicare conditional payments.
CMS has made the following updates to the MMSEA section of the CMS website: http://www.cms.gov/mandatoryinsrep/04_whats_new.asp:
In CMS’ efforts to improve the quality of care, as of October 1, 2008 Medicare will not pay for certain injuries/conditions acquired during inpatient care, these injuries/conditions have been named by CMS as “never events” or “hospital acquired conditions” (HACs).
In order for CMS to accurately coordinate payments made by Medicare to ensure appropriate payment, Medicare requires the HICN (Health Insurance Claim Number) or the SSN and the EIN (Employer Identification Number).