NAMPI Member Portal | Michael Somers | Activity https://staging.member.nampi.net/members/michael_somers/activity/ Activity feed for Michael Somers. Mon, 20 Oct 2025 17:54:03 -0400 https://buddypress.org/?v=2.9.30 en-US 30 hourly 2 7b57ebe8c542a912c8f2a5dea4e5195b Michael Somers started the discussion Sharing MFCU Recoveries with MCE's and Incentive Payments Under 42 CFR 438.6(a) in the forum State Only Forum https://staging.member.nampi.net/nampi-member-forums/discussion/sharing-mfcu-recoveries-with-mces-and-incentive-payments-under-42-cfr-438-6a/ Thu, 22 Feb 2024 19:35:14 -0500 Sharing MFCU Recoveries with MCE's and Incentive Payments Under 42 CFR 438.6(a)

Hello,

Massachusetts is beginning to implement a policy that I know has been implemented in other states where will will begin to share a certain portion of MFCU recoveries with MCE’s if they have made a referral of the provider that led to the recovery. CMS has said that it’s fine to have such an arrangement in our contracts with the MCE’s…

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]]> 18c73eaab064464db5d30cc51d0bc8e8 Michael Somers started the discussion Payment Suspension against 1 provider in group practice in the forum State Only Forum https://staging.member.nampi.net/nampi-member-forums/discussion/payment-suspension-against-1-provider-in-group-practice/ Tue, 14 Feb 2023 20:44:05 -0500 Payment Suspension against 1 provider in group practice

Hi All,

I’m wondering what states consider to be the best practice regarding implementing a payment suspension following a credible allegation of fraud against one member of a group practice, when the group exclusively bills under the group ID not individual ID’s ( and also assuming the group itself nor other members of the group are implicated…

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