On January 4, 2018, CMS released Version 5.5 of the Medicare Secondary Payer MMSEA Section 111 Mandatory Reporting User Guide, simultaneously with an updated WCMSA Reference Guide which we summarized here.
The Medicare Secondary Payer (MSP) Non-Group Health Plan (NGHP) reporting requirements mandated by Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) require plans to report ALL Medicare beneficiaries involving a settlement, judgment or award. The current guide only includes information from the most four current releases and as anticipated, beginning January 1, 2019, the threshold for liability insurance settlements will remain at $750 consistent with the maintenance of $750 threshold for workers compensation and no-fault insurance entities. As responsible reporting entities (RREs) are required to provide a TPOC end date, definitions for the Funding Delayed Beyond TPOC Start Date fields (and related error code descriptions) have been updated.
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