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Defendants Must Heed New Medicare Reporting Obligations

BY John L.A. Lyddane
May 22, 2011

We continue this month with our discussion of the expanded reach of the Medicare reporting requirements under the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA), which as of January 2011 is applicable to liability insurers and self-insured entities. As previously mentioned, MMSEA enhances the Medicare Secondary Payer statute (42 U.S.C. 1395y(b)) by requiring defendants and their insurers to determine if a plaintiff is or may potentially become a Medicare recipient, and to report such status to the Center for Medicare and Medicaid Services (CMS) within the Department of Health and Human Services. (An overview of the reporting requirements may be found at www.cms.hhs.gov/MandatoryInsRep/.)

What Must Be Reported?

The first step in reporting to CMS is to register through the Coordination of Benefits Contractor's secure website for online reporting, www.Section111.cms.hhs.gov. RREs will be assigned a quarterly file submission time frame during which they must submit claim input files.

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