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Through an integrated medical, pharmacy, claims and legal approach, we deliver insights to help navigate the ever‑changing Medicare Secondary Payer landscape.

Recent blog posts

February 13, 2020 · Lavonya Chapman Esq RN CMSP
An unpublished version of the long-waited Section 111 mandatory insurer reporting (MIR) Civil Money Penalties (CMP) has been released and is expected to be published in the Federal Register on 02/18/2020. Read more...
January 28, 2020 · Rafael Gonzalez
Although we certainly hear a great deal about Medicare becoming increasingly more aggressive with primary payers (responsible employers, corporations, insurers, self-insured entities and third-party administrators), the federal government is also becoming just as unforgiving with beneficiaries’ attorneys. Read more...
December 19, 2019
On October 10, 2019, the United States Court of Appeals for the Ninth Circuit published its opinion on California Insurance Guarantee Association v. Azar, concluding that CIGA is not a primary plan under the Medicare secondary payer provisions, but an insurer of last resort, therefore, is under no obligation to reimburse CMS for conditional payments made on behalf of workers’ compensation insureds. Read more...
November 20, 2019 · Rafael Gonzalez
The Centers for Medicare and Medicaid Services (CMS) recently published Version 4.7 of the Medicare Secondary Payer Recovery Portal (MSPRP) User Guide. A notable update in this version is accessibility to Open Debt Reports for account managers. Read more...
November 07, 2019 · Rafael Gonzalez
On October 10, 2019, the Centers for Medicare and Medicaid Services (CMS) published its latest Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide. Read more...
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