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What's New
This section will provide an at-a-glance listing of new information, updates and changes to the MMSEA111 web page.
February 16, 2010
CMS advises all NGHP RREs that the date for first production NGHP Input Files is changed from April 1, 2010 to January 1, 2011, effective immediately.
-NGHP File data exchange testing will continue. All NGHP RREs should now be registered with the COBC, and either in or preparing for file testing status. NGHP file data exchange testing may continue during 2010, as needed.
-All NGHP file data exchange testing will be completed by December 31, 2010. NGHP RREs that have completed file data exchange testing at any time are encouraged to proceed to production file data exchange status.
During the week of February 22, on this Website CMS will post the next version of the "Section 111 NGHP User Guide" and a number of Alerts relating to particular NGHP policy issues.
Also during the week of February 22, on this Website CMS will post an alert for NGHP RREs describing the steps those RREs can take to assure their ongoing compliance with the Section 111 reporting requirements.
New Memo from MSPRC from 10/1/2009
“Proof of Representation” vs. “Consent to Release” for Medicare Secondary Payer
Liability Insurance (Including Self-Insurance),
No-Fault Insurance, or Workers' Compensation
Pursuant to the Privacy Act, Medicare does not release information from a beneficiary’s records without appropriate authorization to do so. For beneficiaries who have filed a claim for liability insurance
(including self-insurance), no-fault insurance, or workers’ compensation, this typically means that the MSPRC will receive either a “proof of representation” document signed by the beneficiary
and the beneficiary’s representative or a “consent to release” document signed by the beneficiary.
Powerpoint presentation from CMS
Medicare Secondary Payer Mandatory Reporting Provisions in Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007
-Directly effected by the law, Liability, WC, Self Funded entities, and No Fault Insurance
-The purpose for Section 111 MSP is to enable CMS to correctly pay for Medicare covered items and services supplied to Medicare beneficiaries by determining primary versus secondary responsibility.
"Enforcements include"
-7/1/2009 is the effective date for required reporting
-Requires carriers to report settlements, judgements and awards involving Medicare beneficiaries to CMS
-$1000.00 per day per claim penalty for non-compliance with the reporting
IMPLEMENTATION TIME LINE:
01.01.09 - 06.30.09 Recommended systems development period
05.01.09 - 06.30.09 Electronic registration via the COBSW for all liability, no-fault, workers compensation RREs.
07.01.09 - 09.30.09 Testing period for all liability, no-fault, workers compensation RREs.
10.01.09 - 12.31.09 All liability, no fault, workers compensation RREs submit thei first Section 111 production files based upon a predetermined schedule with the COBC
01.01.10 All liability, no-fault, workers compensation RREs will be submitting Section 111 production files.
Please sign up via the website www.cms.hhs.gov/MandatoryInsRep for more information and for email alerts!!!
Please contact Michele Earney, Managing Director michele@specialtyallocations.com if you have any questions or concerns. We can offer you some reputable companies that can assist with your data submission.
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