Section 111

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 ar...

Reality Check: Debunking the Myths of Medicare Secondary Payer Compliance

Medicare Secondary Payer (MSP) is a challenging area of compliance for which federal law, regulations, and policy don’t always provide clear answers. This often conflicts with the processes and...

Top 10 Medicare Secondary Payer Trends in 2019

Medicare Secondary Payer (MSP) compliance is a rapidly evolving area that has experienced significant changes in recent years, and 2019 looks to be no different. Policy changes, stricter regulation...

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...

MSPRP Update: CMS Announces a New Self-Reporting Option and Updates to the Multi-Factor Authentication Process

The Centers for Medicare and Medicaid Services (CMS) hosted a webinar focusing on enhancements to its Medicare Secondary Payer Recovery Portal (MSPRP) on December 18, 2018. The improvements discuss...

CMS Preparing to Address Section 111 Reporting Penalties

The Office of Management and Budget (OMB) has issued a notice entitled Civil Money Penalties and Medicare Secondary Payer Reporting Requirements (CMS-6061-P) indicating that the Centers for Medicar...

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...

Countdown to “Full and Final” Settlements: Arizona S.B. 1332

The recent passage of Arizona Senate Bill (S.B.) 1332 provides Arizona claims payers with unprecedented opportunity, finally, to close out their workers’ compensation claims. Under this new law, parties will now be able to reach “full and final” settlement of certain workers’ compensation claims beginning October 31, 2017.

Medicare Section 111 Process Change Eases One Compliance Burden

Medicare’s annual recertification process and update brings welcome news about Section 111 reporting and Responsible Reporting Entities (RREs). RREs will no longer automatically be moved into...