Section 111 Medicare Secondary Payer Mandatory Reporting Program
September 6, 2011
Be Sure You are Using the Current Version of the User Guide
The Section 111 Medicare Secondary Payer Mandatory Reporting program, as applicable to liability insurance (including self-insurance), no fault insurance and workers' compensation, requires that each payment made to a Medicare beneficiary that "does" or "could" include compensation for medical treatment (such as a payment by settlement or judgment), as well as any assumption of ongoing responsibility for medical payments regarding a Medicare beneficiary, be reported to the Centers for Medicare and Medicaid Services (CMS). CMS is using the information reported for both Medicare claims processing and Medicare Secondary Payer recovery actions purposes.
In 2009 CMS published a lengthy User Guide for use by "responsibility reporting entities" that need to comply with the reporting program's requirements. CMS published an amended (3.1) version of the User Guide in 2010.
This is to let our "responsible reporting entity" friends know that CMS has just published another version of the guide - the 311 page "MMSEA Section 111, Medicare Secondary Payer Mandatory Reporting, Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers' Compensation User Guide (Version 3.2, August 17, 2011)" at: www.cms.gov/MandatoryInsRep/Downloads/NGHPUserGuideV3.2.pdf.
This current version of the guide completely replaces the previous (3.1, July 12, 2010) version. However, this is not a "new" guide. CMS has simply amended the previous version to include all of the revisions to that version that CMS had posted as "Alerts" on the Section 111 reporting program website www.cms.gov/MandatoryInsRep.