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John Bair
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CMS Releases Update for MSP Reporting Threshold

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On Tuesday, February 18th, the Centers for Medicare and Medicaid Services (CMS) released an alert regarding the reporting threshold for certain liability settlements.  Per Section 202 of the Medicare IVIG Access and Strengthening Medicare and Repaying Taxpayers Act of 2012 (commonly referred to as the SMART Act), the Secretary of Health & Human Services must calculate and publish a single threshold amount on an annual basis.

Tuesday’s alert states,

“Based on this review, CMS is increasing its current reporting threshold from $300 to $1000.  This new threshold is effective immediately.  This means that physical trauma-based liability settlements of $1000 or less do not need to be reported and recovery of Medicare’s conditional payment amount from these settlements will not be pursued.”

This change comes after CMS reviewed the costs of collecting data and determining Medicare’s recovery claims; the threshold was raised because it simply was not cost-effective to pursue small conditional payment amounts.  A full description of the methodology used to determine the $1000 threshold can be found at here.

Full text of the SMART Act can be found at here.

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