January 12, 2009 - Written Town Hall Transcripts for Liability (including Self-Insurances, No-Fault and Workers' Compensation have been transferred to the new "NGHP" section tab. Future Town Hall Teleconference Dates January 22, 2009 February 25, 2009 March 24, 2009 January 28, 2009 April 22, 2009 New Provisions For Liability Insurance (including Self-Insurance), No-Fault Insurance and Workers' Compensation, found at 42. U.S.C. 1395y(b)(8) Section 111 adds reporting rules; it does not eliminate any existing statutory provisions or regulations. The new provisions do not eliminate CMS' existing processes if a Medicare beneficiary (or his/her representative) wishes to obtain interim conditional payment amount information prior to a settlement, judgment, award,or other payment. - It includes penalties for noncompliance.
- Who Must Report: "an applicable plan." ...[T]he term 'applicable plan' means the following laws, plans, or other arrangements, including the fiduciary or administrator for such law, plan, or arrangement: (i) Liability insurance (including self-insurance). (ii) No fault insurance. (iii) workers' compensation laws or plans."
- What Must Be Reported: The identity of a Medicare beneficiary whose illness, injury, incident, or accident was at issue as well as such other information specified by the Secretary to enable an appropriate determination concerning coordination of benefits, including any applicable recovery claim.
- Data elements determined by the Secretary.
- When/How Reporting Must be Done:
- In a form and manner,including frequency, specified by the Secretary.
- Information shall be submitted within a time specified by the Secretary after the claim is resolved through a settlement, judgment, award, or other payment (regardless of whether or not there is a determination or admission of liability).
- Submissions will be in an electronic format.
Please note: Any information relative to implementing Mandatory Insurer Reporting can be found on the "Overview" page.
Page Last Modified: 01/16/2009 2:36:44 PM
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