CMS Delays Mandatory Insurer Reporting - Amaxx Workers Comp Blog

In a continuing effort to help keep you up-to-date on happenings in Medicare, Gould & Lamb has provided the following summary of important and timely information.

On February 17, 2010, Centers for Medicare and Medicaid Services (CMS) announced it will delay Mandatory Insurer Reporting until 1/1/2011. While reporting is delayed, what needs to be reported has not changed. This means claims/settlements involving Medicare beneficiaries during this interim period still must comply with the Medicare Secondary Payer Statute (MSP) and will be reported to CMS if they meet requirements on 1/1/2011. The reason for the delay is simple, the industry as a whole was not ready for a 4/1/2010 go-live date. In fact, only 3 Reporting Agents successfully moved to production status with CMS as of 2/17/2010. All remaining Reporting Agents were still unsuccessfully testing systems.

Gould & Lamb was one of the three companies to successfully complete testing and be in production for all of our thousands and thousands of RRE IDs. They say, "We have been processing live Medicare Query results for our clients for over 6 months and are ready to proceed with live MIR data feeds beginning 4/1/2010. We encourage our clients to continue to act proactively and not substantively delay their efforts for reporting, pending a review of the soon to be released User Guide (2/22/2010). There is no benefit to delaying until 1/1/2011, unless you are completely unprepared to report until this time, and you only increase your risk and clean up efforts in the future. Bottom-line: The claims you handle today will be reported tomorrow."

If you chose a Reporting Agent who has been unable to pass testing for the reporting requirement after over 2 years of prior notice and development, NOW is a good time to explore your options and make a change without penalty. Select a service prepared to take on additional MIR clients immediately and can successfully integrate both small clients and large clients regardless of needs and system complexities. (workersxzcompxzkit)

The CMS Announcement

CMS advises all NGHP RREs that the date for first production NGHP Input Files is changed from April 1, 2010 to January 1, 2011, effective immediately.

NGHP File data exchange testing will continue. All NGHP RREs should now be registered with the COBC, and either in or preparing for file testing status. NGHP file data exchange testing may continue during 2010, as needed.
All NGHP file data exchange testing will be completed by December 31, 2010. NGHP RREs that have completed file data exchange testing at any time are encouraged to proceed to production file data exchange status.

During the week of February 22, CMS will post on their website the next version of the "Section 111 NGHP User Guide" and a number of Alerts relating to particular NGHP policy issues. Also during the week of February 22, on this Website CMS will post an alert for NGHP RREs describing the steps those RREs can take to assure their ongoing compliance with the Section 111 reporting requirements. http://www.cms.hhs.gov/MandatoryInsRep/04_Whats_New.asp#TopOfPage.

Contact: Nick Collins, Vice President of Strategic Services, nick.collins@gouldandlamb.com; 866-672-3453, Ext 1332. Gould & Lamb welcomes feedback and comments. Contact: 866-672-3453; clientservices@gouldandlamb.com.

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