MMSEA Section 111: Reporting Requirements for Non-Group Health Plans

Posted by Richard Jacobson

I’ll apologize upfront for the acronyms – they are direct from CMS.

MMSEA Section 111As most of you are aware, the implementation of Medicare Secondary Payer Mandatory Reporting for liability insurance (including self-insurance), no-fault insurance and workers’ compensation is well under way. The registration period for NGHP on the Coordination of Benefits Secure Website (COBSW) began on May 1st, and hopefully by now all Responsible Reporting Entities (RRE) are registered and ready to begin the Claim File Testing process on January 1st. While the first Claim Input Files are not due until the second quarter of 2010, the reporting requirements extend to claims for which ongoing responsibility for medicals (ORM) exists as of July 1, 2009.

We are hearing a wide range of reactions to the upcoming reporting requirements and changes to Medicare resources. While we know that Section 111 will have some sort of impact on every GL, WC, and auto carrier and all TPAs, there seems to be little consensus as to the size and breadth of the impact. I would love to hear from you - How are you preparing your staff to handle the upcoming requirements? Will your systems support the new processes? Are you anticipating increased workload to identify ORM claimants who are or may soon be Medicare beneficiaries? How will your settlement process change?