Synergy Blog

MMSEA UPDATE – March 4, 2010

In recent weeks CMS has provided numerous updates regarding Medicare, Medicaid, & SCHIP Extension Act of 2007. In addition to the implementation date being pushed back to January 1, 2011 CMS has attempted to provide clarity in their February 24, 2010 Alerts. These alerts provide information on how NGHP entities can remain in compliance with the requirements and provide further clarification regarding who should report.

Despite CMS’ attempt to provide clarity to a very complex process, it is an industry consensus that the information that has been provided may have only confused matters more.

The most recent information provided by CMS was posted on 03/04/2010:

http://www.cms.hhs.gov/MandatoryInsRep/04_Whats_New.asp#TopOfPage

  • The February, 2010 – 270/271 Health Care Eligibility Benefit Inquiry and Response Companion Guide for Mandatory Reporting NGHP Entities, Version 4, is being posted to the NGHP section page.
  • The January 28 and February 25, 2010 NGHP Town Hall Teleconferences written transcripts are being posted to the NGHP Transcripts section page.

TESTIMONIALS

"I recently engaged Synergy to assist with a complicated PTD settlement involving a substantial Medicare Set Aside. The claimant’s wife has been providing full time attendant care which is not Medicare covered. The Synergy nurse was able to do a full analysis of non-Medicare covered expenses which far exceeded the value of the MSA analysis performed by the carrier’s contracted MSA provider. The non- Medicare figures became the main focus of the settlement negotiations and more than doubled the value of the case. Although I could estimate the attendant care figures, the nurse added in other items that I would not have routinely considered. I also asked Synergy to evaluate the EC’s MSA as well as their prescription review. Synergy offered insight about the prescription donut hole which I did not have a clear understanding about. Again, their insight and information added a great deal of value to the overall settlement. Not only did I learn from Synergy but was able to educate my clients in the process. These are very complex and complicated areas; I will use Synergy again and again!"

Rosemary Eure
Lancaster & Eure

“This service is tremendous, and Synergy Lien Resolution Services is fantastic to work with. All of our cases will be sent through this process.”

David Eaton, Esq.
Eaton & Tirella

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