Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) (P.L. 110-173), adds new mandatory reporting requirements for group health plan (GHP) arrangements and for liability insurance (including self-insurance), no-fault insurance, and workers' compensation. See 42 U.S.C. 1395y(b)(7) & (8). The information below includes a section addressing the Centers for Medicare & Medicaid Services' (CMS) implementation plans as of June 1, 2008, as well as a brief overview of the provisions of the law.
The types of planned documents include, but are not limited to:
• Statutory provisions.• August 1, 2008 Paperwork Reduction Act Federal Register as a link or download.• Supporting statement (with Attachments) for the August 1, 2008 Federal Register PRA notice.• Data elements for reporting related to GHP arrangements and data elements for reporting related to liability insurance (including self-insurance), no-fault insurance, and workers' compensation (part of the PRA supporting statement/Attachments).• Definitions and Reporting Responsibilities (provides details which will assist individuals/entities in determining if they are responsible reporting entities; part of the PRA supporting statement/Attachments).• "ALERT" regarding collecting Social Security Numbers (SSNs), Medicare Health Insurance Claim Numbers (HICNs), and Employer Identification Numbers (EINs), (may be helpful if a responsible reporting entity receives questions about the collection of SSNs and/or HICNs).• "Opportunity for Public Comment" (provides information on submitting comments to CMS through a dedicated e-mail address).• Record layouts.• Registration process for reporting.• Time-frames/timelines (provides details on when registration for reporting must be completed, when reporting will start, time-frames for testing, etc.).• "User Guides" for the submission of data• A suggested model form for the collection of Medicare beneficiary information.• What Medicare claims processing contractors need to know about Section 111.
The new provisions for GHP arrangements found at 42 U.S.C. 1395y(b)(7):
• In a form and manner, including frequency, specified by the Secretary.• GHP reporting will likely be no more than quarterly.• Submissions will be in an electronic format.
The new provisions for Liability Insurance (including Self-Insurance), No-Fault Insurance, and Workers' Compensation found at 42 U.S.C. 1395y(b)(8):
• In a form and manner, including frequency, specified by the Secretary.• Information shall be submitted within a time specified by the Secretary after the claim is resolved through a settlement, judgment, award, or other payment (regardless of whether or not there is a determination or admission of liability).• Submissions will be in an electronic format.