Medicare Compliance

How will the PAID Act affect claims professionals?

Sam Crepeau, Medicare Compliance Counsel, ISG Katie A. Fox, EVP Medicare Compliance, ISG In December 2020, the PAID Act was signed into law. As the most recent modification to the federal Medicare statute, the act requires CMS to provide Medicare Advantage (MA) Plan information when a claimant is queried for their Medicare beneficiary status. The…

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Medicare Compliance

NGHP User Guide – Recent Updates

Sam Crepeau, Medicare Compliance Counsel, ISG. Despite all the upheaval 2020 brought, CMS was unusually busy updating MSP policy with several updates to the NGHP Section 111 User Guides in the waning months of 2020. In keeping with this trend into 2021, CMS recently released another update to the User Guide with significant updates for…

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Medicare Compliance

Civil Monetary Penalties and Handling Conditional Payments

Sam Crepeau, Medicare Compliance Counsel, ISG. Although the specter of CMS imposing Civil Monetary Penalties (CMPs) for Section 111 non-compliance has haunted the MSP landscape since 2007, the intervening time has given all the players an opportunity to launch their respective compliance programs. Now that CMS has issued its Proposed Rule and we await the…

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