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2010 Town Hall Teleconference Dates - All town hall teleconferences are held from 1:00pm to 3:00pm EST unless otherwise noted. Please reference the document titled, "MMESA 111 - Revised - July 30, 2010 NGHP - Notice and Agenda Teleconference Notice and Agenda" located in the Downloads section of this section page. NGHP Policy Question & Answer - September 15th has been rescheduled to September 22nd. Note: All call in information will remain the same. See the Revised August 12, 2010 NGHP Notice and Agenda for 2010 Teleconferences located in the Downloads section below.
- October 14
- November 10
- December 9
NGHP Technical Question & Answer - September 29
- October 28
- November 30
- December 20
New Provisions For Liability Insurance (including Self-Insurance), No-Fault Insurance and Workers' Compensation, found at 42. U.S.C. 1395y(b)(8) Section 111 adds reporting rules; it does not eliminate any existing statutory provisions or regulations. The new provisions do not eliminate CMS' existing processes if a Medicare beneficiary (or his/her representative) wishes to obtain interim conditional payment amount information prior to a settlement, judgment, award, or other payment. - It includes penalties for noncompliance.
- Who Must Report: "an applicable plan." , "...[T]he term 'applicable plan' means the following laws, plans, or other arrangements, including the fiduciary or administrator for such law, plan, or arrangement: (i) Liability insurance (including self-insurance). (ii) No fault insurance. (iii) workers' compensation laws or plans."
- What Must Be Reported: The identity of a Medicare beneficiary whose illness, injury, incident, or accident was at issue as well as such other information specified by the Secretary to enable an appropriate determination concerning coordination of benefits, including any applicable recovery claim.
- Data elements determined by the Secretary.
- When/How Reporting Must be Done:
- In a form and manner, including frequency, specified by the Secretary.
- Information shall be submitted within a time specified by the Secretary after the claim is resolved through a settlement, judgment, award, or other payment (regardless of whether or not there is a determination or admission of liability).
- Submissions will be in an electronic format.
Use of Agents: The applicable NGHP RRE may contract with an entity to act as an agent for reporting purposes. Agents may include, but are not limited to, data service companies, consulting companies or similar entities that can create and submit Section 111 files to the COBC on behalf of the RRE. An RRE may not shift its Section 111 reporting responsibility to an agent, by contract or otherwise. The RRE remains solely responsible and accountable for complying with CMS instructions for implementing Section 111 and for the accuracy of data submitted.
Page Last Modified: 09/08/2010 12:07:35 PM
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