NEW MEDICARE REPORTING REQUIREMENTS:  Medicare Secondary Payer Mandatory Reporting Provisions in  Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007  (See 42 U.S.C. 1395y(b)(7)&(b)(8))

New reporting date for liability matters:  The mandatory reporting date for settlements, judgments and verdicts was July 1, 2009.  The date has now been extended to June 30, 2010.  However, any settlements, judgments and verdicts that occurred as of January 1, 2010 must be reported.

It is now possible to obtain the Conditional Payments on the internet.  Therefore, determining  the approximate amount of the Medicare lien is possible without waiting months to obtain the information from the COB (the Coordination of Benefits Contractor).  Furthermore, by notifying CMS of a possible liability settlement, it should be easier, when the case is settled, to obtain the final conditional payment amount that is owed as a lien.

Liability Insurance (including Self-Insurance), No-Fault Insurance, and Workers’ Compensation:

  05/01/2009 - 09/30/2009 Electronic registration via the COBSW for all liability

insurance (including self-insurance), no-fault insurance, and workers’ compensation RREs.

07/01/2009 Test and production Query Function will be available for those

RREs who have completed registration and are in testing status (the RRE’s signed Profile Report has been received by CMS’ Coordination of Benefits Contractor (COBC)).

01/01/2010 - 03/31/2010 Claim Input File testing period for all liability insurance

(including self-insurance), no-fault insurance, and workers’ compensation RREs.

04/01/2010 - 06/30/2010 All liability insurance (including self-insurance), no-fault

insurance, and workers’ compensation RREs submit their first Section 111 production Claim Input Files based upon a predetermined schedule with the COBC.

07/01/2010 All liability insurance (including self-insurance), no-fault

insurance, and workers’ compensation RREs will be

submitting their Section 111 production Claim Input Files by this date.