Today, July 13, 2015, CMS issued an updated NGHP MMSEA Section User Guide Version 4.7. The updated User Guide can be found here.
The updated User Guide formally incorporates changes previously announced by CMS via recent alerts: the acceptance and processing of Recovery Agent information on Section 111 NGHP TIN Reference Files, the change to criteria required when querying via a partial SSN search (please see our prior blog on this announcement from CMS here), and file naming convention changes. CMS has stated the following about the changes include in User Guide 4.7:
The following updates were made to Chapter IV for this release: CMS had previously used a workaround to allow responsible reporting entities (RREs) to submit third-party administrator (TPA) information on the TIN Reference File. This workaround has now been eliminated, and a permanent solution allows RREs to submit recovery agent name and contact information in dedicated fields. Section 6.3.1 was updated to reflect this process change. The term “recovery agent” replaces the term “TPA” in Section 6.6.5. When submitting a beneficiary using a partial SSN of five digits, excessive numbers of false positive matches resulted. To prevent this, the matching criteria have been changed as follows: when an exact match on the partial SSN is found, then four out of the four remaining data elements must be matched exactly. The matching criteria for HICNs and full SSNs is unchanged. In addition, the URL for accessing the Section 111 Coordination of Benefits Secure Website (COBSW) has been changed to: https://www.cob.cms.hhs.gov/Section111/. Finally, the response file naming convention was changed for NGHP files submitted by SFTP and HTTPS. See Sections 10.3 and 10.4.
Heather Schwartz Sanderson, Esq., MSCC, CHPE, CLMP, CMSP
Chief Legal Officer
Franco Signor LLC