Category Archives: Medicare Reporting Section 111

Blog, Medicare Reporting Section 111, Medicare Secondary Payer News

Today, CMS requested public comment through an Advanced Notice for Proposed Rulemaking (ANPRM) with regard to MMSEA Section 111 Penalties.  Earlier this year, President Barack Obama signed into law the SMART Act.  This law amended the Medicare Secondary Payer Act, and in particular required the Secretary of Health and Human Services to seek public comment on safe harbors for MMSEA …
READ MORE

Blog, Medicare Reporting Section 111, TPOC

Last month, CMS issued version 4 of the MMSEA Section 111 User Guide.   The purpose of the Guide is to provide Responsible Reporting Entities (RREs) with necessary guidance to comply with Medicare Secondary Payer data reporting rules that have been in force for some time.  As a refresher, RREs were required to begin reporting Ongoing Responsibility for Medicals as of …
READ MORE

Franco Signor Introduces New Technologies

06 Nov 2013 Roy Franco No Comments

Blog, Franco Signor News, Medicare Reporting Section 111

SMART Comply™  is the latest of our technologies to assist our Mandatory Insurer Reporting clients in meeting their MSP compliance requirements.  This new product expands our existing Comply suite of technologies that include SFTP and web-based MMSEA Section 111 reporting, conditional payment management, and proactive business intelligence.  SMART Comply leverages our existing business intelligence and expands compliance capabilities to all lines of insurance regardless of the end-user’s experience with MSP.  Improved reporting functionality and …
READ MORE

Blog, Medicare Reporting Section 111, Medicare Secondary Payer News

SMART was signed into law by President Barack Obama on January 10, 2013.  A critical component of this legislation was to have a clear period of limitation established.  Before SMART, various cases were working themselves through the Courts with inconsistent rulings regarding the statute of limitations.  SMART changes this, so long as it is properly triggered. Effective July 10, 2013 …
READ MORE

Blog, Medicare Reporting Section 111

CMS conducted a Town Hall Teleconference for Mandatory Reporting and Liability Insurance (including Self-Insurance), No-Fault Insurance and Workers’ Compensation on April 9, 2013.  The purpose of the call was to address Policy and Technical Support issues with Section 111 reporting; however, callers used the opportunity to enlist substantive CMS responses regarding overall Medicare Secondary Payer Compliance.  CMS was cordial in …
READ MORE

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

In an Alert, dated March 24, 2013, the Centers for Medicare and Medicaid Services has introduced revisions to several Section 111 Reporting Fields as they pertain to NGHP.  The thrust of the Alert is that claims involving decedents are less mandatory and now optional.  The changes are effective April 22, 2013. Franco Signor LLC regularly provides its clients with comprehensive …
READ MORE

New Article Spotlights SMART Law Implications

06 Feb 2013 Jesse Hamby No Comments

Blog, Medicare Reporting Section 111, Medicare Secondary Payer News

A new article in NC Workers’ Comp News provides some insight and detail regarding the new SMART Law.  It is a quick and easy read.  Franco Signor continues to follow developments related to SMART.  Please visit this blog for regular updates. CLICK HERE TO READ THE FULL ARTICLE

Blog, Medicare Conditional Payments, Medicare Reporting Section 111

A common question Franco Signor is asked centers around Medicare Secondary Payer (MSP) penalty enforcement.  When Mandatory Insurance Reporting (MIR) became law in 2007, insurance companies, including self insurance, faced penalties of $1,000 for each day a workers’ compensation or liability settlement, judgment, award or other payment was not reported.   It has taken CMS longer than expected to implement MIR, …
READ MORE

Blog, Medicare Reporting Section 111, RRE

Jeff Signor- Chief Operations Officer The Office of Inspector General (“OIG”), an entity within the Department of Health and Human Services (“HHS”) has released a Work Plan for Fiscal Year 2013.  This Work Plan sets forth various projects to be addressed during the fiscal year by the Office of Audit Services, Office of Evaluation and Inspections, Office of Investigations, and …
READ MORE

Blog, Medicare Conditional Payments, Medicare Reporting Section 111, ORM, Reimbursements

Baumann v. American Family Mutual Insurance Company- 2012- District Court for District of Colorado Facts: Plaintiff was struck by an underinsured motorist on February 5, 2010 and incurred over $200,000 in medical expenses.  Medicare was billed $101,202.98 of that expense and paid $19,523.40 in benefits.  Plaintiff, an insured under two separate automobile policies, issued by Defendant, sought reimbursement for her …
READ MORE

© 2012-2017 Franco Signor LLC