Questions About MMSEA Requirements? Avizent Can Help.

In December 2007, the Medicare, Medicaid and SCHIP Extension Act (MMSEA) was passed. Section 111 of this legislation mandates that certain Responsible Reporting Entities (RREs) report quarterly to the Department of Health and Human Services’ subsidiary, the Centers for Medicare and Medicaid Services (CMS), for Non-Group Health Plans (NGHP) for liability insurance (including self-insurance), no-fault insurance and workers’ compensation in situations where the injured person is Medicare-entitled.

On February 17, 2010, CMS announced that for NGHPs, the mandatory reporting date for the first production claim file had been moved from April 1, 2010 to Jan. 1, 2011. However, CMS also advised that data exchange testing will continue and RREs can begin sending quarterly production files in 2010 if they have been moved to production status. All RREs should be registered with the Coordination of Benefits Contractor and either in or preparing for file testing status. In a November 2010 update, CMS delayed the submission of initial liability claim reports until Jan. 1, 2012 (for claims that do not involve ongoing medical responsibility). To stay current on MMESA Section 111 requirements and deadlines, see the CMS NGHP Alerts web page.

Required Steps

If you have not submitted the Required Notification Form (below) to Avizent, please contact your Account Executive as soon as possible. If you would like Avizent to assist you with the reporting requirements, you must:

For instructions and more information, please refer to the MMSEA letters mailed to Avizent clients in April, June and August 2009; and the Client Bulletin sent via email in March 2010.

MMSEA Materials