Volume 26.01
National Government Services (“NGS”) will begin operating as Wellpoint Federal effective April 1, 2026. Beginning April 1, 2026, NGS will begin transitioning and there are no immediate changes to the provider portals, NGSConnex and NGSMedicare.com.
Additionally:
- Claims submission processed remain the same,
- Claims processing systems remain the same,
- Timeliness and payment cycles remain the same, and
- There will be no interruption to reimbursement.
Additional information is available at WellPoint Federal Provider Frequently Asked Questions (FAQ).
CMS ELIMINATING DOCUMENT FAXING
The Administration Simplification: Adoption of Standards for Health Care Claims Attachments Transaction and Electronic Signatures final rule is projected by CMS to save the health care industry $781 million annually by establishing national standards for the electronic exchange of clinical documentation supporting health care claims. The rule also adopts standards for electronic signatures to ensure secure, authenticated transmission of information.
The rule is effective May 26, 2026, and covered entities must comply by May 26, 2028. Additional information is available at: https://www.cms.gov/newsroom/fact-sheets/administrative-simplification-adoption-standards-health-care-claims-attachments-transactions.
INTEREST ON MEDICARE OVERPAYMENTS (REPAYMENTS)
In accordance with Medicare cost reporting regulations and principles, interest expense is not an allowable cost if the interest is incurred because of:
- An interest assessment on a determined Medicare overpayment, or
- Interest on funds borrowed to repay an overpayment up to the amount of the overpayment, unless the provider has made a prior commitment to borrow funds for other purposes.
When a provider overpayment is determined to exist, and borrowing during the period(s) the overpayment is being repaid, up to the amount of the overpayment is considered a non-allowable cost and any interest is not allowable. Such borrowings are assumed to be related to the overpayment itself and not directly or indirectly related to patient care services. Only in those instances where the provider can show that the borrowing would have been necessary, even if the overpayment had not occurred, will the interest be allowable.
Providers required to file cost reports with the Medicare program should reduce interest expense reported on the cost report by the amount of the interest expense incurred on any repayments whether financed directly by the Medicare program (Extended Repayment Schedule (“ERS”)) or through other financing mechanisms.
Medicare regulations and policies contain numerous provisions relating to the allowability of interest expense based on the nature of the indebtedness and other factors.