Responsible Reporting Entity (RRE)
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).
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”…
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, V. 6.0. They also released updated versions of accepted and excluded ICD-9 and ICD-10 codes for 2021.
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.
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…
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).
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…
CMS releases Section 111 alert regarding the reporting of no-fault insurance and med-pay policy limits on claim input files
Limits on NGHP claim input files in situations where separate Med-Pay and PIP coverages being paid out under a single policy for the same injured party and incident.
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…
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.
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…
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.
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.
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).
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.