The Complete Guide to Medicare Secondary Payer Compliance
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A comprehensive resource for achieving MSP compliance in your insurance settlements!
This all-in-one handbook combines all the resources you need on a daily basis: analysis and practice tips, state specific WCMSA requirements, statutes, public laws, regulations, case summaries with commentary, MMSEA Sec. 111 User Guide, CMS' MSP manual and memos, MMSEA alerts, Glossary and Acronyms, Life tables, and more. This publication will help you take control of your insurance settlements by explaining how to:
• Avoid pitfalls and delays under CMS' policies and procedure
• Comply with reporting requirements and avoid penalties
• Identify cases to submit for CMS review
• Achieve better CMS outcomes and avoid overly inflated MSAs
• Find defensible and less costly allocations for future medical expenses
• Submit acceptable proof for rated age for purposes of CMS review
• Avoid rejection of MSA proposals for inadequate prescription drug information
• Understand MSA evaluations and financial options for funding MSAs
• Determine when MSAs should be used in liability settlements and the settlement language to use
• And much more!
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Table of contents
Part I. Guide to MSP Compliance
Chapter 1. Development of MSP Enforcement
Chapter 2. MMSEA Section 111 Reporting Requirements
Chapter 3. Conditional Payments
Chapter 4. Medicare Set-Aside Arrangements
Chapter 5. Workers' Compensation Medicare Set-Aside Arrangements
Chapter 6. State Specific WCMSA Requirements
Chapter 7. Liability and Claims and the MSP
Chapter 8. Specialty Claims
Chapter 9. Enterprise Risk Management Issues Surrounding MSP Compliance
Part II. Case Summaries with Commentary
Part III. United States Code and Public Laws
Part IV. Code of Federal Regulations
Part V. Medicare Secondary Payer (MSP) Manual
Part VI. MMSEA Section 111 User Guide
Part VII. CMS Memorandums
Part VIII. Medicare Secondary Payer Recovery Portal (MSPRP) User Manual
Part IX. Workers' Compensation Medicare Set-Aside Arrangement (WCMSA) Reference Guide
Part X. Glossary and Acronyms
Part XI. United States Life Tables