Responsible Reporting Entity (RRE)

CMS releases new NGHP Section 111 User Guide (Version 5.6)

The Centers for Medicare and Medicaid Services (CMS) has released an updated Section 111 User Guide (Version 5.6, July 1, 2019 ) regarding non-group health plans (liability, no-fault and workers’ compensation). This...

Think about Your Thresholds: Preventing Errors to Avoid CMS Penalties

We’ve been taking a look at some of the ways RREs can attempt to achieve full CMS compliance and avoid potential penalties that may be coming soon. One area to consider more closely is file thresholds. Upon submission...

Big reforms are coming to Michigan PIP - How the changes will impact Medicare Secondary Payer compliance

On May 30, 2019, Michigan Governor Gretchen Whitmer signed into law Michigan Senate Bill 1 (S.B. 1) [1] which makes significant changes to Michigan’s personal injury protection (PIP) system, including allowing policy...

Avoiding Penalty Problems by Ensuring Data Accuracy

With CMS (Centers for Medicare and Medicaid Services) penalties on the horizon, we’ve been exploring how RREs (Responsible Reporting Entities) can be proactive in avoiding fines. We covered timely reporting in our...

To Avoid CMS Penalty Exposure Time Is of the Essence

The timely reporting of ORM (Ongoing Responsibility for Medicals) and TPOC (Total Payment Obligation to Claimant) data to the Centers for Medicare and Medicaid Services (CMS) is of key importance to insurers, especial...

With Civil Money Penalties Looming, It’s Time to Fine-Tune CMS Reporting

For insurance carriers and self-insureds—known as Responsible Reporting Entities (RREs)—Section 111 can be a daunting obligation. In fact, it’s the only Medicare Secondary Payer (MSP) compliance area associated with a...

CMS Releases New NGHP Section 111 User Guide

The Centers for Medicare and Medicaid Services (CMS) has updated its  Non-Group Health Plan (NGHP) Section 111 User Guide . The new guide is styled as Version 5.5 and is dated January 7, 2019. Per CMS, changes were ma...

CMS Releases New WCMSA Reference Guide and NGHP Section 111 User Guide

The Centers for Medicare and Medicaid Services (CMS) has updated its Workers' Compensation Medicare Set-Aside (WCMSA) Reference Guide and Non-Group Health Plan (NGHP) Section 111 User Guide . These new updates include...