Flagship introduces end-to-end solutions for Medicare's reporting, recovery requirements

Flagship Services Group, Inc., a company providing expertise in Medicare compliance for insurance carriers, self-insured entities, attorneys, and state and local government agencies, today announced its unique end-to-end solutions for the compliance challenges the industry faces relating to the Centers for Medicare and Medicaid Services' (CMS) reporting and Medicare Secondary Payer (MSP) recovery requirements. Flagship's integrated solutions combine best practices for the claims, legal, and medical fields in order to manage claims from inception to close.

"There is tremendous confusion and misinformation about what parties are required to do in order to comply with Section 111 reporting and the Medicare Secondary Payer recovery provisions," noted Kendell Gracey, Executive Vice President and Chief Legal Counsel of Flagship Services Group. "Parties may think they are in compliance, but in reality they are creating new liabilities every day. So, Flagship assembled a team of experts including claims executives, attorneys, and nurses to dispel the confusion and provide our clients with desperately needed solutions to complex problems for each claim, whether it's litigated or not."

Section 111 requires Responsible Reporting Entities (RREs) to report eligible claims and settlements to the Centers for Medicare and Medicaid Services (CMS), in order to identify the parties and the amount of money involved in a claim or settlement. Before these claims are settled and reported, the Medicare Secondary Payer (MSP) statute requires parties to consider and protect the value of Medicare's past, present and/or future financial interests to ensure that Medicare is not paying for claims that should be covered by another payer source.

CMS is now focusing on both Section 111 and MSP requirements. Those who fail to comply with these federal laws are subject to a $1,000 penalty per day per claim and/or double damages, interest, and personal liability.

Many parties who think they are compliant with Medicare's reporting and recovery requirements risk incurring penalties and liabilities because:

• CMS' continual changes and postponements of reporting obligations have created confusion within the industry
• MSP requirements for recovery, including the negotiation and payment of settlements, are inconsistent and poorly understood

Insurance carriers, state government entities, and attorneys have turned to Flagship to provide clarity to the complexities and ever-changing requirements of the federal laws associated with Medicare. Flagship's cutting-edge, customized products and services are tailored to the world of Medicare compliance and deliver a combination of claims, legal, medical, and proprietary IT solutions to the market.

"Our mission is to bring efficiency and effectiveness to the Medicare recovery and reporting process. In doing so we protect our clients from risk while ensuring compliance with federal laws," noted Brian Cox, CEO of Flagship Services Group. "We aggressively manage each step in the claims process with best practices based on Medicare guidelines and our expertise to ensure that no penalties are incurred, the settlement is accurate, and that our clients are protected from liabilities and costs. While we understand that Medicare's interests must be protected we also firmly strive to position our clients where, if they have to pay Medicare, they pay what they owe and not a penny more."