Breaking: CMS Recovery Practice Ruled Improper under the MSP

In an important new case—CIGA v. Burwell, 2017 WL 58821 (C.D. California, January 5, 2017)—the court ruled that the CMS practice of seeking full reimbursement of a medical provider’s single charge—even where some unsegregated portion of that charge relates to services not covered by a workers compensation plan—was improper under the Medicare Secondary Payer Statute […]

Zero Allocations: CMS backs down from drastic changes

Marty Cassavoy

As we outlined in a blog post last week, there’s been a lot of buzz surrounding the Centers for Medicare & Medicaid Services’ (CMS) approval of zero allocations. From the moment CMS proposed changes to the process, we outlined why we strongly believe that the workers compensation industry should not stand idly by while wholesale […]

CMS News Alert: Zero allocations are far from over

Martin-Cassavoy

The Centers for Medicare and Medicaid Services (CMS) made news this week by purportedly “correcting” their position on zero allocations. At ISO Claims Partners, we strongly believe that the industry should fight CMS on this and not blindly accept what amounts to an illogical application of CMS’s own stated policies. Background CMS’s purported position basically […]

CMS Updates Medicare Secondary Payer Recovery Portal

Sean Deane

On October 11, 2016, the Centers for Medicare and Medicaid Services (CMS) released a new, updated version of the Medicare Secondary Payer Recovery Portal (MSPRP) User Guide. A link to the guide (Version 3.5) can be found here. As many of our readers know, one of the key issues stemming from the transition of a […]

The SPARC Act may have implications for future Medicare Advantage Plan rulings

Marty Cassavoy

On September 22, Congressmen Tim Murphy (R-PA) and Ron Kind (D-WI) introduced legislation designed to clarify the Medicare Secondary Payer (MSP) standing on Medicare Part D plans. Text of the new legislation—known as the Secondary Payer Advancement, Reconciliation, and Clarification (SPARC) Act—can be found here. The SPARC Act seeks to provide clarity as to when […]

Unique Solutions to 2016 Industry Challenges

Insurers are facing tough challenges in 2016 and ISO Claims Partners is working with you to meet these challenges in unique ways. As the industry confronts greater pressures to reduce expenses and increase efficiency, carriers need to partner with solutions providers that embody agility and inventiveness. We are honored and proud that our parent company, […]