Section 111 Update & Summary: CMS Holds Section 111 Town Hall Call

By Kate Riordan  |  December 17, 2014

The Centers for Medicare & Medicaid Services (CMS) held a Section 111 Town Hall Teleconference on Wednesday, December 10, 2014.

This Town Hall teleconference addressed several policy and technical issues related to a number of recent Alerts and other updates released by CMS.

The following summarizes the issues CMS discussed on this call:

  • Recent Alerts John Albert from CMS and Jeremy Farquhar from the Benefits Coordination & Recovery Contractor (BCRC) discussed CMS’ recent Alerts regarding the agency’s plans to allow RREs to use the last five digits of a claimant’s Social Security Number as an identifying number starting January 5, 2015 and the new Recovery Agent concept which will become effective July 13, 2015.
    •  Regarding CMS’ new SSN policy, Mr. Albert and Mr. Farquhar explained that, despite the short notice provided by CMS, the agency planned on moving ahead with the January 5th effective date. As part of this change, CMS will permit RREs to provide either a full SSN or the last five digits of an SSN in order to perform a query match or with claim input files. CMS will return the full Health Insurance Claim Number (HICN) with the query. Mr. Albert and Mr. Farquhar explained that, while CMS prefers that RREs obtain the HICN or full SSN to a partial SSN, the accuracy of the two options is comparable.
    • Regarding the Recovery Agent Alert, Mr. Albert and Mr. Farquhar reiterated that the new Recovery Agent process will become available to RREs in July 2015. Per this Alert, this new process will allow both the recovery agent and RRE to receive copies of recovery correspondence and allow the recovery agent (in some scenarios) to directly investigate the claim on the RRE’s behalf without the need for additional written authorization.
  • Multifactor authentication –  
    Mr. Albert explained that CMS would be moving forward in the coming year and
    “no later than January 1, 2016” with a multi-factor authentication process that will allow authorized third parties to view unmasked, claim-specific information in the MSPRC Portal. This unmasked information will include specific providers and dates of service, which are presently only available to individual Medicare beneficiaries.
  • Questions and Answers
    Callers presented several questions to CMS representatives. Among the topics discussed were: Accident & Health policies, where CMS confirmed that one-time death benefit awards were not reportable; loss of consortium; and foreign insurance. Little new ground was covered in these topics. If you have a particular question surrounding one of these topics, or any other issue of concern, please do not hesitate to contact the author.

Kate Riordan

Kate Riordan is the director of Medicare Secondary Payer (MSP) initiatives at ISO Claims Partners. She has well over five years of experience in completing Medicare Set-Asides and obtaining CMS approvals, with a concentration in California claims. Kate graduated Bowdoin College and Suffolk University Law School and is a Medicare Set-Aside Certified Consultant.