Section 111, February 25, CMS Town Hall Meeting
http://www.cms.hhs.gov/MandatoryInsRep/03_Liability_Self_No_Fault_Ins [...]
http://www.cms.hhs.gov/MandatoryInsRep/Downloads/NGHPComplianceAlert0 [...]
http://www.cms.hhs.gov/MandatoryInsRep/Downloads/NGHPAlertRREsWhoMustR [...]
In the Town Hall Conference on February 25, 2010, The Centers for Medicare and Medicaid Services (CMS) announced an extension of the reporting dates for both Total Payment Obligation to the Claimant (TPOC) and Ongoing Responsibility for Medicals (ORM). The required reporting dates are at the first link above.
Total Payment Obligation to the Claimant (TPOC) date has been extended from January 1, 2010 to October 1, 2010.
Ongoing Responsibility for Medicals (ORM) date has been extended from June 1, 2009 to January 1, 2010.
CMS representatives indicated that the all RREs will be obligated to report after January 1, 2011 during the designated reporting quarters that were previously assigned. If testing has been completed and an RRE is in production status, then CMS has indicated that the RRE may begin reporting at the designated quarters any time after April 1, 2010.
Confirmation of the above information will be published in the MMSEA Section 111 NGHP User Guide - Version 3.0 which the CMS Representatives announced should be posted on the CMS website within the next 48 hours at the second link above.
Additionally, CMS issued two alerts on February 25, 2010 with regard to MMSEA Section 111 Reporting.
NGHP RRE Compliance
The CMS Alert indicates that a Section 111 NGHP RRE will be compliant with its Section 111 reporting requirements if it registers for reporting with the CMS Coordination of Benefits Contractor (COBC), and once registered the RRE engages in data exchange testing with the COBC, and once testing is completed the RRE begins and continues with regular Section 111 production data exchanges with the COBC. The RRE will then be participating in the Section 111 process in the manner prescribed by CMS. This process is discussed in detail in the “Section 111 NGHP User Guide”. More specific descriptions of the participation requirements are published at the CMS website at the third link above.
NG HP MMSEA Section 111 Reporting: Who Must Report
This Alert provides information regarding who/what entity is an MMSEA Section 111 Responsible Reporting Entity (RRE) for Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers’ Compensation. CMS has clarified the definition of an RRE in situations involving: a Deductible v. Self-Insured Retention (SIR), Acquisitions, Bankruptcy, Deductible Issues v Re-Insurance, Stop Loss Insurance, Excess Insurance, Umbrella Insurance, etc., Foreign Insurers, Fronting Policies, Liquidation, Multiple Defendants, Multi-National Organizations, Self-Insurance Pools, State established “assigned claims fund”, Subrogations by an Insurer, and Workers’ Compensation. Specific details can be found at the CMS website at:
Burns White will continue to monitor and review any and all changes regarding Mandatory Insurer Reporting and advise you of the most recent developments. We are available to handle any and all Medicare Mandatory Insurer Reporting issues and if you have any questions or concerns, please contact any of our Medicare Attorneys.
http://www.cms.hhs.gov/MandatoryInsRep/Downloads/NGHPComplianceAlert0 [...]
http://www.cms.hhs.gov/MandatoryInsRep/Downloads/NGHPAlertRREsWhoMustR [...]
In the Town Hall Conference on February 25, 2010, The Centers for Medicare and Medicaid Services (CMS) announced an extension of the reporting dates for both Total Payment Obligation to the Claimant (TPOC) and Ongoing Responsibility for Medicals (ORM). The required reporting dates are at the first link above.
Total Payment Obligation to the Claimant (TPOC) date has been extended from January 1, 2010 to October 1, 2010.
Ongoing Responsibility for Medicals (ORM) date has been extended from June 1, 2009 to January 1, 2010.
CMS representatives indicated that the all RREs will be obligated to report after January 1, 2011 during the designated reporting quarters that were previously assigned. If testing has been completed and an RRE is in production status, then CMS has indicated that the RRE may begin reporting at the designated quarters any time after April 1, 2010.
Confirmation of the above information will be published in the MMSEA Section 111 NGHP User Guide - Version 3.0 which the CMS Representatives announced should be posted on the CMS website within the next 48 hours at the second link above.
Additionally, CMS issued two alerts on February 25, 2010 with regard to MMSEA Section 111 Reporting.
NGHP RRE Compliance
The CMS Alert indicates that a Section 111 NGHP RRE will be compliant with its Section 111 reporting requirements if it registers for reporting with the CMS Coordination of Benefits Contractor (COBC), and once registered the RRE engages in data exchange testing with the COBC, and once testing is completed the RRE begins and continues with regular Section 111 production data exchanges with the COBC. The RRE will then be participating in the Section 111 process in the manner prescribed by CMS. This process is discussed in detail in the “Section 111 NGHP User Guide”. More specific descriptions of the participation requirements are published at the CMS website at the third link above.
NG HP MMSEA Section 111 Reporting: Who Must Report
This Alert provides information regarding who/what entity is an MMSEA Section 111 Responsible Reporting Entity (RRE) for Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers’ Compensation. CMS has clarified the definition of an RRE in situations involving: a Deductible v. Self-Insured Retention (SIR), Acquisitions, Bankruptcy, Deductible Issues v Re-Insurance, Stop Loss Insurance, Excess Insurance, Umbrella Insurance, etc., Foreign Insurers, Fronting Policies, Liquidation, Multiple Defendants, Multi-National Organizations, Self-Insurance Pools, State established “assigned claims fund”, Subrogations by an Insurer, and Workers’ Compensation. Specific details can be found at the CMS website at:
Burns White will continue to monitor and review any and all changes regarding Mandatory Insurer Reporting and advise you of the most recent developments. We are available to handle any and all Medicare Mandatory Insurer Reporting issues and if you have any questions or concerns, please contact any of our Medicare Attorneys.
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