Category Archives: Medicare Reporting Section 111

Blog, Medicare Jurisdiction, Medicare Reporting Section 111, Medicare Secondary Payer News

As part of the Strengthening Medicare and Repaying Taxpayers (SMART) Act, the Centers for Medicare & Medicaid Services (CMS) has implemented optional MFA services which are now available on the MSPRP. MFA is the use of two or more different authentication factors to verify the identity of a user. Verified users will now have access to view unmasked claims data …
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Blog, Medicare Jurisdiction, Medicare Reporting Section 111

CMS has announced that it will be holding a NGHP Town Hall on July 28, 2015 from 1-2 PM EST. The announcement states that CMS will discuss the transition of the NGHP recovery workload to the Commercial Repayment Center during its opening comments. After the opening comments, CMS will address technical and policy questions regarding Section 111 Mandatory Insurer Reporting. …
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CMS Publishes NGHP MMSEA Section 111 User Guide 4.7

14 Jul 2015 Heather Sanderson No Comments

Blog, Medicare Reporting Section 111

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 …
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CMS Issues Technical Alert Regarding Partial SSNs

19 Jun 2015 Heather Sanderson No Comments

Blog, Medicare Reporting Section 111, Medicare Secondary Payer News

Yesterday, CMS issued a technical alert regarding the partial use of SSNs. As mentioned in our prior blog, CMS had recently become aware that the submission of partial SSNs was erroneously causing the return of false positives in matches with regard to Medicare eligibility. The new alert dated June 18, 2015 essentially provides that in order to determine if individuals …
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CMS Query Issue

02 Jun 2015 Heather Sanderson No Comments

Blog, Medicare Reporting Section 111

In November 2014, pursuant to the SMART Act, CMS implemented a process where RREs could use a partial SSN (last 5 digits) where the RRE was unable to obtain the full SSN when reporting ORM and TPOCs. A recent issue has been identified where RREs have been using only a partial SSN during the Section 111 query process. Franco Signor has been …
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Blog, Legal/Legislative News, Medicare Conditional Payments, ORM

Yesterday, CMS held a webinar on the applicable plans newly created right of appeal that went into effect on April 28, 2015. Because of the Strengthening and Repaying Taxpayers (SMART) Act, CMS was required to develop regulations outlining how an applicable plan (workers’ compensation, liability, automobile insurance, no-fault insurance, including self- insurance law or plans) would exercise this right. As …
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CMS Updates MMSEA Section 111 User Guide

09 Apr 2015 Roy Franco No Comments

Blog, Medicare Jurisdiction, Medicare Reporting Section 111

CMS released yesterday version 4.6 of the MMSEA Section 111 User Guide, dated April 6, 2015. Responsible Reporting Entities (RREs) when encountering instances of the disposition code “DP” for possible duplicate beneficiary situations, are instructed on what actions to take to remain in compliance. The new disposition code was added because of the SMART legislation which required CMS to curtail …
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Updated MMSEA User Guide, Version 4.5

03 Feb 2015 Jeff Signor No Comments

Blog, Medicare Reporting Section 111

CMS released this morning another update to the MMSEA User Guide, version 4.5. The link to the new User Guide can be found here: http://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Mandatory-Insurer-Reporting-For-Non-Group-Health-Plans/NGHP-User-Guide/NGHP-User-Guide.html The purpose of the release was to integrate into the User Guide, at Chapter 3, CMS rules regarding the reporting of losses involving implantation, exposure and ingestion.  These rules were clarified last year by Policy and …
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