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MMSEA 111 What's New

What's New

This section will provide an at-a-glance listing of new information, updates and changes to the MMSEA111 web page.

Important Note: To comment or make inquiry regarding a Mandatory Insurer Reporting document and/or posting, please utilize the designated mailbox only. PL110-173SEC111-comments@cms.hhs.gov.

January 25, 2012

  • The MMSEA 111 - Quick Reference Guide Version 1.0 - January 19, 2012 - For Non-Group Health Plans (NGHP) Insurers  has been posted to the Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers' Compensation (NGHP) section page.

January 18, 2012

  • ALERT - January 10, 2012 - Liability Insurance (Including Self-Insurance), No-Fault Insurance and Workers' Compensation Responsible Reporting Entities (RREs) Are Not Required to "Self-Report" Ongoing Responsibilities for Medicals (ORM) Outside of the MMSEA Section 111 Reporting Process has been posted posted to the Additional NGHP Alerts section page.

  • A revised CBT Non-Group Health Plan Curriculum dated January 17, 2012 has been posted to the MMSEA 111 Computer Based Training (CBT) section page.

January 5, 2012

  • MMSEA 111 - Revised - November 9, 2011 - User Guide - Liability Insurance (Including Self-Insurance), No-Fault Insurance and Workers' Compensation User Guide, Version 3.3 [PDF 2.78MB] was posted to the Liability Insurance, Self-Insurance, No-Fault Insurance and Workers' Compensation (NGHP) section page.
  • ALERT - November 28, 2011 - ALERT: Group Health Plan (GHP)- New Employer Size Error (SP91)  Employer Size Error SP91 vs. SPES was posted to the GHP Alerts section page.
  • ALERT - December 20, 2011 - Information on the Submission of Third Party Administration (TPA) Information for Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers' Compensation Responsible Reporting Entities (RREs) [PDF 27.99KB] was posted to the Additional NGHP Alerts section page.
  • December 14, 2011 NGHP teleconference transcript will be posted to the NGHP Transcripts section page.
  • The December 9, 2010 NGHP teleconference transcript will be moved to the Mandatory Insurer Reporting section page.

September 30, 2011 

MEDICARE SECONDARY PAYER PROGRAM

IMPORTANT UPDATES

As part of the Centers for Medicare & Medicaid Service (CMS) efforts to continuously improve its Medicare Secondary Payer (MSP) program; CMS has posted the following information to the MSP websites:

  1. An ALERT delaying the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) Section 111 MSP reporting requirement for certain liability insurance (including self-insurance) settlements, judgments, awards, or other payments is posted posted at www.cms.gov/MandatoryInsRep on the Additional NGHP Alerts section page.
  2. Policy guidance related to Exposure, Ingestion, and Implantation issues, and December 5, 1980, is now posted at www.cms.gov/MandatoryInsRep/NGHP Alerts section page and www.cms.gov/COBGeneralInformation.
  3. An ALERT related to Qualified Settlement Funds, under Section 468B of the Internal Revenue Code, is now posted at www.cms.gov/MandatoryInsRep/MMSEA 111 Alerts section page.
  4. A policy memorandum, for liability insurance (including self-insurance), on the acceptance of the treating physician's certification, and its impact on the issue of protecting Medicare's interests with respect to future medicals is now posted at www.cms.gov/COBGeneralInformation.

In addition, on September 30, 2011, the Medicare Secondary Payer Recovery Contractor will implement a self-service information feature to its customer service line.  This feature gives callers the ability to get the most up-to-date Demand/Conditional Payment amounts, and the dates that those letters were issued, without having to speak to a customer service representative.  The self-service feature will be available for extended hours, and callers will have the option of requesting information on multiple cases during one phone call.

Beginning in October 2011, CMS will implement an option to pay a fixed percentage of certain physical trauma-based liability cases with settlement amounts of $5000 or less.  Detailed information on this option will be posted as an ALERT, on or before October 21, 2011, on the MSPRC website at www.MSPRC.info.

Upcoming improvements to the MSP program, expected within the next 3-9 months, include the following:

  • The implementation of a MSPRC portal, where the beneficiary/representative can obtain information about Medicare's claim payments, demand letters, etc., and input information related to a settlement, disputed claims, etc. 
  • The implementation of an option that allows for an immediate payment to Medicare for future medical costs that are claimed/released/effectively released in a settlement.
  • The implementation of a process that provides Medicare's conditional payment amount, prior to settlement in certain situations.  

                                             GHP and NGHP Tin Validation requirements are now operational

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Related Links Inside CMS
Section 111 RRE Registration: Coordination of Benefits Website (COBSW)
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Page Last Modified: 01/25/2012 1:34:23 PM
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