The U.S. Centers for Medicare and Medicaid Services posted a fact sheet on the four-step process that went into effect April 28 allowing workers' compensation carriers and other insurers to challenge what the agency seeks to recover in conditional payments.
CMS in February finalized rules for "applicable plans," which include work comp, no-fault insurance and liability coverage, to appeal a determination that Medicare has paid for medical care on a claim when those costs should have been borne by the carrier.
The process for appealing a CMS determination includes:
Asking the...
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