MMSEA Section 111 Medicare Secondary Payer Mandatory Reporting Group Health Plan User Guide Updated as of July 19, 2013

The Centers for Medicare and Medicaid Services (“CMS”) updated the Medicare, Medicaid, and SCHIP Extension Act of 2007 (“MMSEA”) Section 111 Medicare Secondary Payer (“MSP”) Mandatory Reporting Group Health Plan (“GHP”) User Guide as of July 19, 2013.

Section 111 of the MMSEA requires secondary payers such as GHP providers, liability insurers (including self-insurance), No-Fault and workers’ compensation insurers to determine the Medicare entitlement of all eligible claimants and report certain information about those claims to the CMS.

The User Guide is for use by all Section 111-GHP responsible reporting entities.

To view a copy of the updated User Guide, click here.

Specifically, the updates are:

• References to the Medicare Secondary Payer (“MSP”) Recovery Contractor (MSPRC) have been replaced with references to the Commercial Repayment Center (“CRC”).  CMS has transitioned all the functions and workloads related to GHP MSP recovery to the CRC, with the exception of provider, physician or other supplier recovery.
• Clarification on how to accurately report a Coverage Termination Date (Field 11) on the MSP Input File has been provided.  When this date is incorrectly reported, Medicare erroneously rejects claims for primary payment.
• As a result of the redesign of the Medicare and Coordination of Benefits pages on the CMS.gov Web site, all outdated hyperlinks have been replaced.
• The registration process for computer based training (“CBT”) has been modified.  Users no longer have to register for CBTs.  The CBTs can be accessed directly from the CMS Web site.

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