New information regarding Mandatory Insurer Reporting for Group Health Plans (GHPs) and GHP Town Hall Events is posted here as it becomes available.
March 6, 2023 – CMS to Host Section 111 Group Health Plan (GHP) Reporting Webinar
CMS will be hosting Section 111 GHP Reporting webinar on March 29, 2023. Complete webinar information is available in the Downloads section below.
February 16, 2023 – Top 10 Section 111 Group Health Plan Reporting Errors Chart Now Available
A new chart titled Top 10 Section 111 Group Health Plan Reporting Errors, covering the period of July 1 – December 31, 2022, is now available in the Download section below. Descriptions of these and all reporting errors are available for review in the GHP User Guide.
January 9, 2023 – Updated MMSEA Section 111 Group Health Plan (GHP) User Guide Now Available
The updated MMSEA Section 111 GHP User Guide version 6.7 has been posted to the GHP User Guide page. Refer to Chapter 1 for a summary of updates.
November 4, 2022 – New Alert titled Reminder to Group Health Plan (GHP) Responsible Reporting Entities (RRE) Regarding Correction of SPT0 Errors Now Available.
A new Alert titled Reminder to Group Health Plan (GHP) Responsible Reporting Entities (RRE) Regarding Correction of SPT0 Errors, is now available on the GHP Alerts page.
November 4, 2022 – Implementation of Part D Reporting Hierarchy for Section 111 Mandatory Insurer Reporting for Group Health Plans (GHP)
Recently there has been an increase in overlapping reporting of prescription drug records by various entities as part of the Section 111 mandatory Group Health Plan (GHP) reporting process. To reduce the risk of potentially conflicting information, reporting hierarchy business rules will be implemented for prescription drug records. These will be similar to those governing MSP occurrences and will be applied to all Medicare Part D primary as well as supplemental prescription drug record transactions, effective April 2023.
Full details regarding the hierarchy implementation can be found in the following sections of Version 6.6 of the GHP User Guide. Please see:
- Section 9.10 Prescription Drug Hierarchy Requirements
- Appendix C: Non-MSP File Specifications
- Appendix D: Section 111 GHP SP Error Codes
October 3, 2022 – Updated MMSEA Section 111 Group Health Plan (GHP) User Guide Now Available
The updated MMSEA Section 111 GHP User Guide version 6.6 has been posted to the GHP User Guide page. Refer to Chapter 1 for a summary of updates.
April 4, 2022 – Updated MMSEA Section 111 Group Health Plan (GHP) User Guide Now Available
The updated MMSEA Section 111 GHP User Guide version 6.5 has been posted to the GHP User Guide page. Refer to Chapter 1 for a summary of updates.
Downloads
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Section 111 Group Health Plan (GHP) Reporting Webinar Announcement (PDF) -
Top 10 Section 111 Group Health Plan Reporting Errors - July 1- December 31, 2022 (PDF) -
SUPPORT Act Group Health Plan Town Hall Presentation – May 7, 2020 (PDF) -
Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act Group Health Plan (GHP) Town Hall Announcement (PDF) -
Group Health Plan (GHP) Reporting for Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act – Frequently Asked Questions and Answers – December, 2019 (PDF) -
The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act - Section 111 Group Health Plan (GHP) Reporting Changes Webinar #3 (PDF) -
April 18, 2019 - Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, Section 111 Group Health Plan (GHP) Reporting Changes Webinar (PDF) -
The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act - Section 111 Group Health Plan (GHP) Reporting Changes Webinar #2 (PDF)