Medicare, Medicaid and SCHIP Extension Act of 2007 - What is MMSEA Section 111?
The MMSEA provisions can possibly make it more difficult for plaintiffs and defendants to settle single event and mass tort personal injury claims after July 31, 2009. Defense and plaintiffs must practice some new procedures on the front end of cases in order to minimize disruption on the back end.
On July 12, 2010 CMS issued Version 3.1 of the MMSEA User Guide. This document addresses how the new reporting provisions should be interpreted and implemented. Further guidance can be found on the CMS website: www.cms.hhs.gov/MandatoryInsRep
Section 111 of The Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) institutes mandatory reporting requirements for group health, liability (including self-insurance), no-fault insurers and workers' compensation insurers/plans. Insurers must report certain prescribed claims information in regard to Medicare beneficiaries to the Secretary of Health and Human Services.
What entities are considered to be "Responsible Reporting Entities (RREs)"?
42 U.S.C. §1395y(b)(8) provides that the "applicable plan" is the RRE and defines "applicable plan" to mean 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; and iii) workers' compensation laws or plans.
Further resources for agents/insurers can be found on the Medicare Secondary Payer website
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