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Responsible Reporting Entity (RRE)

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January 22, 2021

CMS releases new NGHP Section 111 User Guide (Version 6.2, January 11, 2021)

CMS has released an updated Section 111 NGHP User Guide (Version 6.2, January 11, 2021) regarding non-group health plans (liability, no-fault, and workers’ compensation).

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November 13, 2020

CMS releases new NGHP Section 111 User Guide (Version 6.1) and Technical Alert

CMS’ recently released NGHP Section 111 User Guide and Technical alert outline the eventually elimination of the ‘SP31’ error notices and updates to the “soft error”…

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October 6, 2020

CMS releases new NGHP Section 111 User Guide (Version 6.0) and updated accepted/excluded ICD code listings

On 10/5/20, CMS released an updated Section 111 NGHP User Guide, Version 6.0. They also released updated versions of accepted and excluded ICD-9 and ICD-10 codes for…

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August 14, 2020

CMS holds Section 111 NGHP update webinar

On 8/13, CMS held a webinar on Section 111 non-group health plan reporting. The webinar covered NGHP Section 111 reporting best practices and MSPRP enhancements.

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August 11, 2020

OIRA releases updated information Section 111 CMPs

OIRA released an updated notice on the status of CMS’s Section 111 civil money penalties proposals. CMS released the proposals in February 2020 and opened a public…

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July 1, 2020

CMS releases new NGHP Section 111 User Guide (Version 5.9)

CMS has released an updated Section 111 NGHP User Guide (Version 5.9, June 29, 2020) regarding non-group health plans (liability, no-fault and workers’ compensation).

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June 16, 2020

Key changes to Michigan PIP start July 1, 2020 – Medicare Secondary Payer compliance impact

While individuals will still be able to elect unlimited PIP coverage, for applicable policies issued or renewed after 7/1/20, PIP plans with different coverage limits may…

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June 12, 2020

CMS releases Section 111 alert regarding the reporting of no-fault insurance and med-pay policy limits on claim input files

CMS issued a new Section 111 alert on the reporting of personal injury protection, and Med-Pay policy limits on non-group health plan claim input files in situations…

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May 1, 2020

Court finds state of Rhode Island compliant with Section 111 despite its inability to obtain social security information to determine Medicare status and enforces settlement

The U.S. District Court in Ruiz v. Rhode Island was called upon to address whether a personal injury settlement should be enforced even though the defendant was unable to…

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April 21, 2020

CMS’s Section 111 civil money penalties comment period closes

With the comment period closed, the focus now turns to when CMS will issue its Final Rule, which will comprise of the agency’s official CMP regulations. 

Image1lon9
April 9, 2020

Medicare enables COVID-19 ICD-10 code for Section 111 reporting

The CDC issued a bulletin advising it is implementing the new ICD-10 U07.1 for “COVID-19, virus identified” in an off-cycle update effective 4/1/20, to code the COVID-19…

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February 18, 2020

CMS’s Section 111 penalty proposals are here

CMS has released its long-awaited Section 111 civil money penalty proposals for non-group health plans, as well as group health plans.

Reports
November 20, 2019

CMS’s new Section 111 alert addresses MBI reporting

CMS has issued an updated Section 111 Alert pertaining to non-group health claims (NGHP) regarding the Medicare Beneficiary Identifier (MBI) reporting.

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July 15, 2019

CMS releases new NGHP Section 111 user guide (Version 5.6)

On 7/1/19, CMS released an updated Section 111 User Guide (Version 5.6) regarding non-group health plans (liability, no-fault and workers’ compensation).

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June 27, 2019

Think about your thresholds: Preventing errors to avoid CMS penalties

One way responsible reporting entities can attempt to achieve full CMS compliance and avoid potential penalties is to closely consider file thresholds.