Successful Appeal to CMS ALJ Yields $80K Reduction in Conditional Payments
Posted on March 15, 2023 by Tower MSA Partners
In response to a Medicare conditional payment demand, payers can access a five-level appeals process, including a hearing before a Centers for Medicaid and Medicaid Services (CMS) administrative law judge (ALJ). Most conditional payment demand appeals are resolved at the…
CMS Extends Deadline for Publication of Final Section 111 Penalties Rule
Posted on February 20, 2023 by Daniel Anders
There was much expectation that the Centers for Medicare and Medicaid Services (CMS) would meet the February 18, 2023 deadline to release a final rule on Section 111 reporting civil money penalties (CMPs). However, it was not to be. CMS…
Tower Partners: People Behind the Settlements Interview with Kevin Puckett of KP Underwriting
Posted on February 16, 2023 by Tower MSA Partners
Tower MSA Partners is pleased to launch “Tower Partners: People Behind the Settlements.” This quarterly series will dig into the elements that go into smooth, cost-effective settlements and introduce Tower’s team members and corporate partners who make them possible. First…
Posted on January 26, 2023 by Tower MSA Partners
Tower’s MSP Compliance blog analyzes the nuances of Medicare Set-Asides (MSAs) and other aspects of Medicare Secondary Payer Compliance. It covers topics like re-reviews and the termination of ongoing responsibility for medicals (ORM), along with tweaks to WCMSA Reference Guide….
Premier Webinar: Zeroing in on $0 MSAs
Posted on January 25, 2023 by Tower MSA Partners
A $0 MSA remains an option in some workers’ compensation case settlements, although strict criteria must be met if CMS approval is necessary. It is essential then for claims professionals to understand this criteria as steps taken early in claims…
A Claims Professional’s Guide to Common MSP Acronyms and Abbreviations
Posted on January 19, 2023 by Daniel Anders
People in the MSP compliance business rattle off acronyms and abbreviations, such as AWP, MMSEA, and TPOC like it’s second nature. People immersed in Section 111 reporting and Medicare Set-Asides understand the abbreviations, but most people listening to us do…
CMS to Provide RREs with Response File on ORM Record Changes
Posted on January 11, 2023 by Daniel Anders
Starting July 2023, Responsible Reporting Entities (RREs) can access updates/changes that another source has made to their claims for Ongoing Responsibility for Medicals (ORM). The Centers for Medicare and Medicaid Services (CMS) announced this in an update to its MMSEA…
Top 5 MSP Stories of 2022 & What to Watch for in 2023
Posted on January 4, 2023 by Daniel Anders
As we launch into 2023, here’s a look back at the top five Medicare Secondary Payer (MSP) compliance stories of 2022 and what to watch for this year. Addition of Non-Submit MSA Policy to CMS WCMSA Reference Guide 2022 certainly…
Happy Holidays From Your Friends at Tower MSA Partners
Posted on December 21, 2022 by Tower MSA Partners
We’ve had an exciting year of growth at Tower MSA Partners in 2022 and would like to extend our appreciation to you, our valued partners, who have supported us. Whether this is your first year as a Tower client, or one who…
Tower Releases White Paper on Future Medicals in Liability Settlements
Posted on December 13, 2022 by Tower MSA Partners
This past October, the Centers for Medicare and Medicaid Services (CMS) withdrew its proposed rule on future medicals in liability settlements from review by the White House Office of Information and Regulatory Affairs (OIRA). (See CMS Withdraws Proposed Rule on…
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