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Posts Tagged ‘MSA’

Revised CMS NGHP Implementation Timetable – Mandatory Reporting

Thursday, April 1st, 2010

CMS has provided an updated implementation timeline for MMSEA Section 111 reporting:

http://www.cms.hhs.gov/MandatoryInsRep/01_Overview.asp#TopOfPage

 • 05/01/2009

Electronic registration via the Section 111 COBSW began for all liability insurance (including self- insurance), no-fault insurance and workers’ compensation RREs (NGHP RREs) excluding foreign RREs.

• 07/01/2009

Test and production Query Input Files accepted for NGHP RREs that completed registration and are in a testing status (the RRE’s signed Profile Report has been received by the COBC).

• 01/01/2010 – 12/31/2010

Claim Input File testing period for all NGHP RREs.  

• 04/05/2010

Electronic registration commences via the Section 111 COBSW for foreign NGHP RREs (those that are based in countries outside the United States and have no Internal Revenue Service-assigned tax identification number and/or US mailing address).

• 01/01/2011 – 03/31/2011

All NGHP RREs must submit initial Section 111 Claim Input production files to the COBC according to assigned file submission timeframes for their RRE IDs.

• 04/01/2011

All NGHP RREs must be reporting production Claim Input Files on a quarterly basis by this date.

CMS WC MSA UDPATE

Friday, March 26th, 2010

CMS has posted the following WC MSA Update:  http://www.cms.hhs.gov/workerscompagencyservices/01_overview.asp?

March 23, 2010

The CMS is moving forward with the development of the Workers’ Compensation Medicare Set-Aside Portal (WCMSAP). As you know, the WCMSAP will allow for the electronic submission of WCMSA proposals for future medical and future prescription drug costs on a more expedited basis. With the introduction of the WCMSAP web portal, scheduled for the first quarter of 2011, WCMSA submitters will receive a real-time acknowledgement of their proposal submissions. Rest assured that comprehensive educational material will be provided on this website for all interested parties before the implementation of the WCMSAP. Keep checking back for updates that will be coming from CMS about the WCMSA Web Portal.

**MMSEA ALERT** Additional Information Regarding MMSEA Changes 2/25/2010

Thursday, February 25th, 2010

CMS Provides Additional Guidance for the Implementation of MMSEA on January 1, 2011

MMSEA Section 111- CMS What’s New 02/25/2010:  http://www.cms.hhs.gov/mandatoryinsrep/04_whats_new.asp?

 

February 25, 2010

The following documents are being posted to the NGHP section page: 

  • NGHP User Guide, V3.0 dated February 22, 2010
  • Revised February 24, 2010 Notice and Agenda for 2010 Teleconferences for NGHP denoting new date for the cancelled February 10th call.

Live reporting for MMSEA Section 111 will take place on January 1, 2011.  The 7/1/2009 reportable claims date has been retracted. The following 2010 settlements are now reportable:

  • October 1, 2010 (on or post):  Lump sum awards
  • January 1, 2010 (on or post):  Expected ORM  (Ongoing Responsibility to Medical)

 MMSEA Section 111- CMS Alert 02/24/2010:

http://www.cms.hhs.gov/MandatoryInsRep/09_Alerts.asp#TopOfPage

In order to be compliant with MMSEA Section 111 RRE’s must: Read the rest of this entry »

MMSEA Update & News – October 2009

Wednesday, October 28th, 2009

Notes from the recent CMS Town Hall Teleconference on October 22, 2009:

We are rapidly approaching the date for live reporting to CMS for all Workers Compensation, Liability, and No Fault claims, 4/1/2010.  The registration deadline for RRE’s (insurers) was 9/30/09, but CMS has opted to leave the registering process open.  CMS has ensured the industry that those entities that were not registered prior to 10/1/09 will not be penalized, but it is expected that all RRE’s will be registered by the end of the year. 

Due to misinterpretation of the law under MMSEA plaintiff attorneys have been left overwhelmingly frustrated with the varying opinions in regard to whether or not a Liability MSA is now required under MMSEA?  By now plaintiff attorneys should be apprised that, although MMSEA Section 111 has nothing to do with Medicare Set-Asides, it does not dismiss the necessity of protecting Medicare’s interest in Liability cases.

Read the rest of this entry »

FJA Seminar – October 15, 2009 – Liability MSAs

Wednesday, October 28th, 2009

On October 15 – 16, 2009  Delta Settlement Solutions was a sponsor at the Florida Justice Association Seminar, held in Orlando, FL.   The event was a great way to meet and greet our colleagues and introduce our services.  Erica Cooper, Manager of Medicare Services and Compliance of Lien Settlement Solutions (a Delta Company) gave a comprehensive presentation regarding compliance under the MSP statute, titled “CMS Compliance Does Not Have To Be A Nightmare”.   Below, Erica gives her thoughts, observations of the event, and additional insight into Liability MSAs.

 The Florida Justice Association is a great organization.   I have had the opportunity to learn the admirable members of the FJA as well as the broad education and strong foundation it provides to our legal community.  It is a privilege to support a group such as the FJA.

Many of the participants in attendance expressed great concern when handling Liability cases and whether or not an MSA is required?  For whatever the reason the industry has made an already complex matter more difficult to implement in attorneys day to day practice.  So allow me to provide as much clarity as I can regarding this matter.

We first have to remember that MMSEA Section 111 has nothing to do with Medicare Set-Asides.  Secondly an MSA is only considered such when an allocation is submitted to CMS.  Otherwise, when an analysis of future medical costs is created it is simply an allocation. 

Protecting Medicare’s interest is relevant to all Workers Compensation, Liability, and No Fault claims.  For both past and future medical expenses paid and that can be expected to be paid.  Lack of a “formal” review process by CMS for proposed Liability MSA’s, does not dismiss the necessity of an allocation to protect Medicare’s interest for future medical expenses.  When addressing this topic there are two questions: 

1)      Do you need to allocate?

2)      Do you need to submit the allocation to CMS for review? 

Read the rest of this entry »

Are MSA’s required in Liability Cases?

Friday, September 25th, 2009

 A Medicare Insider’s Clarification on MSA Confusion

medicare maze

According to Section 111 of the MMSEA (Medicare, Medicaid &SCHIP Extension Act), primary payers are to (1) identify the Medicare eligibility status of plaintiffs and (2) report all Medicare beneficiaries to Health and Human Services when there is a settlement, judgment, or award that is taking place in Workers Compensation, Liability, and No Fault claim.  CMS has reiterated that the MMSEA provision does not change or eliminate any existing obligations for the handling of Medicare Set Asides (“MSA”).  It is crucial to understand that the Section 111 MMSEA reporting requirements are a completely separate matter from MSAs.

The misinformation that trial lawyers have received is creating great confusion with regard to what is required under the Medicare Secondary Payer Act (“MSP”) when settling future medical in a liability claim.  Is an MSA necessary or not?  Those entities that have taken the position that an MSA is “required” in liability settlements likely have financial incentives for taking that position.  The only answer regarding whether you have to set up an MSA in liability cases is that there simply are no definitive answers.  With the absence of specific statutory or regulatory language mandating that an MSA be completed in a liability claim, it is left up to the trial lawyer to interpret current law and CMS pronouncements to decide whether it is appropriate to establish an MSA.

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