CMS is serious about protecting Medicare’s funds. For years, the agency had policies that were not always enforced. These included sizeable civil monetary penalties for failure to comply with Section 111 reporting rules. They also included denying payment for medical treatment when another payer was responsible.

But things are changing. CMS has denied payments and has taken steps toward collecting those penalties.

Claims Journal Quotes Dan Anders on CMS Enforcement

Claims Journal Editor Jim Sams explores these actions in a recent article, which quotes Tower MSA Partners Chief Compliance Officer Dan Anders.

Why Section 111 Penalties and Non-Submit MSAs Matter

Section 111 reporting rules and non-submit MSAs are important compliance issues for insurers, claimants, attorneys, and claims professionals.

As CMS increases enforcement activity, parties involved in workers’ compensation settlements need to understand how reporting, Medicare payment responsibility, and MSP compliance may affect claim outcomes.

Read the Full Claims Journal Article

Read the full Claims Journal article here:

CMS Rules on Settlement Reporting May Sting Insurers and Claimants Both (claimsjournal.com)