CMS Updates MMSEA Section 111 NGHP User Guide & More

It has been a busy season for CMS, with several new updates and announcements which we will break down here.

October 20, 2018 CMS announced that the Coordination of Benefits Recovery Center will mask the HICN/SSN on all COB&R outgoing letters effective April 2019 In accordance with the Social Security Number (SSN) Fraud Prevention Act of 2017. The Medicare Beneficiary Identifier (MBI) will appear in full, while the first five digits of the Social Security Number will be masked with asterisks (e.g., *****1234A). All outgoing hard copy and electronic letters will reflect this change.

On October 1, 2018, CMS released an update to the MMSEA Section 111 Non Group Health Plan (NGHP) User Guide, Version 5.4 which may be found on their website.This version updates contact information with an escalation process for contacting key personnel. Responsible Reporting Entities (RREs) are reminded to use a consistent and uniform format to report claim policy numbers, standardize a format for reporting policy numbers. In addition, Appendix I and J have been updated to list the excluded ICD.9 and ICD.10 diagnosis codes for purposes of MMSEA Section 111 reporting, effective January 1, 2019.

CMS released an updated Workers Compensation Medicare Set Aside (WCMSA) Reference Guide on October 1, 2018, which may be found here.

The new WCMSA Reference Guide incorporates the use of the New Medicare Cards that we announced in our blog (read here). CMS is executing a unique identifier, rather than a beneficiary social security number to improve identify protection, a result of the Social Security Number Removal Initiative (SSNRI).

September 19, 2018, CMS hosted a webinar about the benefits of using the Commercial Repayment Center Portal (CRCP) on September 19, 2018. Besides a discussion about how to use the portal, CMS shared news of future enhancements that will allow submission of payments for recovery cases. The presentation is available as a resource from CMS here.

On August 16, 2018, the Medicare Secondary Payer Recovery Portal (MSPRP) hosted a Webinar to discuss process improvements. The Webinar may be accessed here.

We will continue to keep you informed as CMS updates and announcements are released.

Care Bridge International, Inc.

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MSP Compliance Bridge, LLC


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