Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA Section 111) adds mandatory reporting requirements with respect to Medicare beneficiaries who have coverage under group health plan (GHP) arrangements as well as for Medicare beneficiaries who receive settlements, judgments, awards or other payment from liability insurance (including self-insurance), no-fault insurance, or workers’ compensation.
The purpose of the Section 111 MSP reporting process is to enable the Centers for Medicare & Medicaid Services (CMS) to pay appropriately for Medicare-covered items and services furnished to Medicare beneficiaries by determining primary versus secondary payer responsibility. Section 111 requires Responsible Reporting Entities (RREs) to submit information specified by the Secretary in a form and manner (including frequency) specified by the Secretary. The Secretary requires data for both Medicare claims processing and for MSP recovery actions, where applicable. RREs will submit information through an electronic file exchange. The actual data submission process will take place between the RREs and the CMS Benefits Coordination & Recovery Center (the BCRC). The BCRC will manage the technical aspects of the Section 111 data submission process for all Section 111 RREs.
All implementation instructions, including reporting user guides, are available on CMS' dedicated Section 111 web pages for Group Health Plans at https://go.cms.gov/mirghp, and for Non-Group Health Plans at https://go.cms.gov/mirnghp.
The Section 111 COB Secure Website (COBSW) was developed for Section 111 RRE registration and file exchange.
September 2024
This page was last modified on: September 2024
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