Centers for Medicare & Medicaid Services (CMS)

1/23/2025 - 5 min read

CMS will end one-year waiting period to file WCMSA Amended Review requests

CMS has a released an Alert advising that effective 4/7/2025, Amended Review requests “will be allowed at any time a WCMSA case is approved.”

1/22/2025 - 11 min read

CMS releases WCMSA Reference Guide 4.2-CMS to end review of $0 WCMSAs

CMS releases an updated WCMSA Reference Guide (Version 4.2, January 17, 2025).

1/10/2025 - 4 min read

CMS releases updated MSPRP User Guide (Version 6.4)

CMS released an updated MSPRP User Guide with changes to the security protocols for the Multi-Factor Authentication process.

1/8/2025 - 3 min read

CMS releases Section 111 NGHP User Guide (Version 7.9)

CMS has released an updated Section 111 NGHP User Guide regarding reporting related to NGHPs (liability, no-fault and workers’ compensation).

Colleagues Conversing Around Conference Table

12/19/2024 - 5 min read

CMS retains its $750 “Low Dollar” threshold for 2025

CMS has announced its low-dollar reporting and recovery thresholds for 2025, retaining the current $750 low-dollar threshold for certain cases.

Office Working Concentrating On Laptop Screen

12/11/2024 - 8 min read

New Section 111 NGHP User Guide (Version 7.8) – CMS adds new section regarding WCMSAs

CMS released an updated Section 111 NGHP User Guide (Version 7.8) regarding S.111 reporting related to non-group health plans.

10/28/2024 - 31 min read

CMS Unveils New Webpage Resource for NGHP Section 111 CMPs

CMS introduces two new resources related to NGHP Section 111 civil money penalties (CMPs): the NGHP Civil Money Penalties webpage and the CMPs workflow.

10/22/2024 - 17 min read

CMS addresses NGHP Section 111 penalties during its October 17 webinar

CMS conducted its second webinar on NGHP Section 111 CMPs, covering various topics related to CMPs for NGHP RREs.

10/16/2024 - 4 min read

Verisk’s Data-Driven MSA: A Solution for Low-Dollar TPOC/WCMSA Reporting

Manage low-dollar workers’ compensation settlements ($25,000 or less) for Medicare beneficiaries under CMS’s updated process.

10/11/2024 - 17 min read

CMS releases Section 111 NGHP User Guide (Version 7.7)

CMS released an updated Section 111 NGHP User Guide for reporting on non-group health plans: liability, no-fault, and workers' comp.

10/1/2024 - 1 min read

CMS to host Section 111 NGHP CMPs Webinar on October 17th

CMS to host a Section 111 NGHP Section 111 CMP that will include reminders about Final Rule, the auditing process and important dates.

9/25/2024 - 13 min read

Voluntary testing for TPOC/WCMSA reporting starts October 7, 2024

Reminder for Section 111 NGHP RREs: CMS’s voluntary testing for the new TPOC/WCMSA reporting starts October 7, 2024.

9/25/2024 - 8 min read

CMS’s CMPs final rule is “applicable” October 11, 2024

CMS's CMPs final rule becomes “applicable” on October 11^th regarding Section 111 penalties.

9/17/2024 - 13 min read

CMS’s Section 111 daily CMPs max rate for NGHP reporting is now $1,474

A new Section 111 update raises the maximum daily CMP for NGHP reporting.

9/11/2024 - 4 min read

Are Your WCMSA Protocols Being Followed? How Verisk’s MSA Link Can Help

CMS’ new process will require insurers to report several WCMSA data points as part of settlements involving Medicare beneficiaries.