Piatt Consulting News Letters

Piatt Consulting publishes news letters on a regular basis (monthly or quarterly) help RREs keep up with the changes to MMSEA Section 111 Mandatory Insurer Reporting and includes editorial comments about how Section 111 reporting relates to Medicare Secondary Payer laws and recovery practices.  Some news letters may also include a special topic of general interest to our community of readers.

Insiders Guide

After Section 111 Mandatory Insurer Reporting was enacted by Congress, it fell to CMS to determine how the new law would be implemented.  The result of those long meetings in hot rooms in Baltimore are the GHP and NGHP User Guides.  As the then Medicare Secondary Payer Recovery Contract (MSPRC) Program Director, I participated in many of the meetings.  My goal at that time was to get data that would make our recovery job at the MSPRC easier.  In this news letter I hope to be able to shed some light on some of the more arcane aspects of reporting as well as tie what we are reporting to the bigger picture -- Medicare Secondary Payer (MSP) laws.

I would also like to share some insights gathered over time about the MSP laws and Health and Human Services (HHS) regulations that implement these laws.  Coupling my experience at the CMS with a great deal of legal research honed by invitations to speak at conferences and consulting engagements with both legal defense and plaintiff firms, I have a developed a more complete picture of how Medicare and the Courts treat the law.

Still Confused?

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Piatt Consulting offers Medicare Reporting Agent Services, Software for Reporting Agents and Medicare Claims Resolution (About Us).

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In order to reduce the size of the electronic news letter, only the first few paragraphs of some, but not all, articles are included in the actual news letter with links to the articles posted below.  To read the entire news letter please feel free to sign up from one someone may have passed along, or contact us via email to request that you be added to our list  This email address is being protected from spambots. You need JavaScript enabled to view it.

December 2012

Reporting: OIG Section 111 Audits, Thresholds and No-Fault Settlements
MSP: Analysis of H.R. 1063 - Strengthening Medicare and Repaying Taxpayers called the “SMART” ACT
Special Topic: Update with input from MAGI WEST conference attendees

July 2012

Reporting: Medicare issued three alerts about new reporting thresholds
MSP: CMS proposes regulations for Future Medicals (including liability) CMS-6047-ANPRM
MSP: CMS publishes guidance to provides to help stop improper denials (find it here)
Specal Topic: Clinical Trials -- more sponsors are reporting and David Piatt at MAGI West

February 2012

Reporting: Medicare claims are being denied more often: Is it a problem?
MSP: Case Study -- When a workers’ compensation carrier has ORM and there is a separate tort settlement
Special Topic: Medicare Reporting: A Boon to Clinical Trial Sites

September 2011

Reporting: Reporting as self-insured is generally necessay
MSP: The legal implications of reporting ORM
Special Topic: Clinical Trials

October 2011
Special Topic: Flurry of CMS Alerts: What is going on with reporting liability?
MSP: The MSPRC Portal -- Promises of a Brighter Future
MSP: A Brief Note on Liability Set-Asides

November 2011

Reporting. No Fault Settlements

MSP: ORM Reimbursement Demands - Workers Compensation and No-Fault

Special Topic Healthcare Providers may sue insurers under Medicare Secondary Payer