August 2010: With Mandatory Insurer Reporting set to finally take effect on January 1, 2011, the insurance industry, litigants, beneficiaries and legal practitioners continue to face uncertainty regarding Medicare, Medicaid and SCHIP Extension Act (MMSEA) Section 111 Reporting Requirements. This is particularly true in mass tort litigation. (Read Mass Tort Statement)

August 2010: Another error code has been added in the 3.1 Version of the NGHP User’s Guide. It is FP 31. This happens only in a rather complicated situation, and hopefully will not happen often, but we do need to notify you of it because we have actually seen this condition on a recently submitted production file. (Read Error Code Statement)

July 2010: CMS releases the newest MMESEA, Section 111 User Guide: Version 3.1. To view the entire Guide Book. (Guide Book V 3.0)

May 2010: Medicare Secondary Payer-Workers’ Compensation-INFORMATION

The purpose of this memorandum is to clarify guidance provided in the Centers for Medicare & Medicaid Services’ (CMS’) April 3, 2009 and July 1, 2009 procedure memoranda regarding prescription drugs administered to Medicare beneficiaries...(Read Alert)

March 2010 : ALERT for Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers’ Compensation: WHO MUST REPORT

This document provides information regarding who/what entity is a MMSEA Section 111 Responsible Reporting Entity (RRE) for Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers’ Compensation. (Read Alert)

February 2010 :

CMS DELAYS IMPLEMENTATION OF SECTION 111 MANDATORY REPORTING TO JANUARY 1, 2011

The Centers for Medicare and Medicaid Services (CMS) has announced a delay in the implementation of Section 111 Mandatory Reporting for Non-Group Healthcare Providers (NGHP), otherwise known as Liability Insurance (including Self-Insurance), No-Fault Insurance, and Workers' Compensation plans, from April 1, 2010 to January 1, 2011. According to the CMS statement (see below), the testing period which was to have ended March 31, 2010, will now be extended to the end of 2010.

Nonetheless, CMS further states that Responsible Reporting Entities (RREs) which have completed their testing may proceed with reporting of files prior to January 1, 2011. This statement from CMS also does not change the reportable claims which remain as follows:

• All individuals who are Medicare eligible and have received a settlement, judgment, award or other payment since January 1, 2010; or
• All individuals for whom an RRE has assumed ongoing responsibility for medical payments (ORM) since July 1, 2009.

What should you be doing now!

September 2009: CMS releases an ALERT: Complaince Regarding Obtaining Indivual HICNs and/or SSNs for Non-Group Health Plan (NGHP). (Read Alert)

The included model language is recommended by MedAllocators for entities attempting to obtain HICN & SSN information from a claimiant. (Model Language)

The September MSA Insider addresses these ALERTS. (View Insider)

August 2009: CMS releases the newest MMESEA, Section 111 User Guide: Version 2.0. To see a summary of changes view the August 2009 MSA Isider or view the entire Guide Book. (Guide Book V 2.0)

August 2009: This draft document provides additional detail regarding who/what entity is a MMSEA Section 111 Responsible Reporting Entity (RRE) for Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers’ Compensation. (Memo)

July 2009: ALERT to address Workers' Compensation payments (Memo)

April 2009: A memorandum is set forth by CMS regarding the methodology of pricing future prescription drug treatment costs/expenses in Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) proposals. (PDF)

March 2009: CMS Release MMSEA, Section 111 Guide Book. (Guide Book)

November 2008: CMS Definitions for an Responsible Reporting Entity (RRE)

CMS Definitions of an RRE (extracted pages)

Original Supporting Statement for the MSP

October 2008: Update on MSP Mandatory Reporting:

Reporting Act Interim Record Layout

Reporting Act Timeline

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