CMS Makes ORM Changes

On December 24, 2015, the Centers for Medicare and Medicaid Services (CMS) announced that they will make changes to the Medicare Claim Payments when Ongoing Responsibility (ORM) for Medicals are reported.

Effective January 1, 2016, in situations where an insurer or workers' compensation entity has reported to CMS that it has ORM for specific care or an injury, CMS' claims processing contractors will use the information provided by the insurer or workers' compensation entity to determine whether Medicare is able to make primary payment for those claims. Insurers and workers' compensation entities that notify Medicare that they have ORM are strongly encouraged to report accurate ICD-9 or ICD-10 codes. Medicare's claims processing contractors will use this information to pay the claim accordingly. For a copy of the announcement, please click here >>