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.
CMS announced in March of 2009 that the mandatory quarterly electronic claims reporting would begin January 1, 2010. They later delayed the reporting date until April 1, 2010. On February 17, 2010, CMS announced that for NGHPs, the mandatory reporting date for the first production claim file has been moved from April 1, 2010 to January 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. All testing must be completed by December 31, 2010.
CMS is also issuing a new MMSEA Section 111 NGHP User Guide and three related Alerts. The Alerts change the retroactive date for reporting certain types of claims and change the definition of an RRE in situations where an entity has a deductible plan – a major shift in policy. The Alerts are available on the MMSEA Section 111 website.
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:
- Return the Required Notification Form to your Account Executive
- Register on the CMS Coordination of Benefits secure website as soon as possible, and identify Avizent as your Account Designee (or Account Manager).
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
Required Notification Form
Registration Overview
Quick Reference Guide for Section 111 Registration for All RREs
MSA-CMS Statement
MMSEA Section 111 User Guide
MMSEA Mandatory Reporting FAQs
SCHIP May 11 2009 Alert
July 17, 2009 Alert
August 18, 2009 Alert - HICNSSN Form
August 24, 2009 Alert