Section 111 Reporting

7/9/2024 - 3 min read

Section 111 NGHP User Guide (V7.6): Updates "Cumulative Injury" Definition & TIN Errors

CMS releases new Section 111 NGHP User Guide (V7.6) for NGHPs (liability, no-fault, and workers’ compensation) reporting.

4/26/2024 - 14 min read

CMS Holds a TPOC/WCMSA “Question & Answer” Session to Further Discuss its New Section 111 Reporting Process

On April 25th, CMS held a “Q and A” session to discuss its plans to require S.111 RREs to report various WCMSA data points as part of its TPOC reporting trigger.

4/9/2024 - 1 min read

CMS to Hold Second TPOC/WCMSA Webinar on April 16, 2024 at 2:00 p.m. ET

CMS will be holding its second TPOC/WCMSA webinar on April 16th to discuss its plans to use Section 111 TPOC reporting to collect WCMSA data as part NGHP Section 111 reporting.

2/26/2024 - 7 min read

CMS Releases New Information About TPOC/WCMSA Data Collection Process

A February Alert provided more information on CMS’s plans to require RREs to report WCMSA data as part of its TPOC reporting trigger.

1/30/2024 - 21 min read

CMS Releases Section 111 NGHP User Guide (Version 7.4)

CMS released an updated Section 111 NGHP User Guide (Version 7.4) regarding reporting related to non-group health plans (NGHPs).

1/23/2024 - 20 min read

CMS Discusses NGHP Section 111 Civil Money Penalties on its First CMPs Webinar

CMS’s Section 111 ‘penalties’ webinar discussed different CMPs changes, including, how CMPs will be calculated, the audit process, notice/appeal, and safe harbors.

1/4/2024 - 1 min read

Login Details Now Available for CMS Section 111 Penalties Webinar

CMS just provided new information on how to attend its January 18, 2024 NGHP CMPs webinar. Read the article to learn how you can attend.

12/5/2023 - 1 min read

CMS to Hold NGHP Section 111 Penalties Webinar

CMS will be holding a Section 111 civil money penalties (CMP) webinar for (NGHPs) on January 18, 2024 at 1:00 p.m. ET.

9/28/2023 - 16 min read

OIRA Issues New Notice Regarding Section 111 Civil Money Penalties - Notice Addresses the Proposed Rule’s Economic Impact Designation

As many will recall, earlier this year the (CMS) extended the timeline to release its Section 111 civil money penalties (CMP) “Final Rule” until February 18, 2024.

8/7/2023 - 12 min read

The United States District Court for Connecticut dismisses a Medicare Advantage claim for “double damages” – rules that insurer’s Section 111 reporting not sufficient to establish standing

Interesting new Medicare Advantage recovery case, the United States District Court for Connecticut in MSP Recovery Claims, Series LLC v. Travelers Indemnity Company

6/28/2023 - 10 min read

Mid-Year “Round-Up” 2023 – keeping track of Medicare and other claims updates (ICYMI)

We are at the mid-point for 2023! It has been a busy year in so many claims areas. Time to regroup on the key claims updates over the past months – ICYMI style!

6/7/2023 - 11 min read

CMS holds webinar to discuss the Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File “opt-in” feature (starts July 2023) and other Section 111 items

(CMS) held a webinar where the agency discussed its upcoming Section 111 Non-Group Health Plan (NGHP) Unsolicited Response File “opt-in” feature (starts July 2023)

6/7/2023 - 20 min read

CMS releases Section 111 NGHP User Guide (Version 7.2, June 5, 2023) – new changes include: NGHP Unsolicited Response File, ORM reporting trigger, ORM termination, and HEW software

(CMS) has released an updated Section 111 NGHP User Guide regarding Section 111 reporting related to non-group health plans.

Gavel on a white background with a small shadow.

5/23/2023 - 9 min read

The United States District Court for Massachusetts dismisses a Medicare Advantage claim for “double damages” – rules that insurer’s Section 111 reporting does not establish standing to sue

The U.S. District Court for Massachusetts dismisses Medicare Advantage claim for “double damages”—rules insurer’s Section 111 reporting doesn't establish standing to sue.

5/1/2023 - 10 min read

CMS’s Query Process and non-binary/unspecified gender designations – current issues and considerations

Section 111 non-group health plan (RREs) involves the inability to submit non-binary or unspecified gender designations as part of the (CMS’s)