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CMS Announces Dates and Agenda for Remaining 2009 Town Hall Teleconferences, Releases Companion Document for the HIPAA Guidelines for Electronic Transactions |
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Industry News Updates
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Written by Tom Matson
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Monday, 01 June 2009 09:42 |
On May 26, 2009 the Centers for Medicare and Medicaid Services (CMS) announced the dates and agenda for their remaining 2009 Town Hall Teleconferences. It is important to distinguish that the CMS will conduct a handful of conferences specifically relating to technical questions surrounding the Section 111 data exchange process. There will be a separate group of teleconferences that have been setup to address questions pertaining to Section 111 compliance in general.
Also included in this announcement is a companion document created to supplement the HIPAA guidelines for electronic transactions for Non-GHP Entities. The document provides information on the transactions sets needed to transmit data to, as well as receive data from, the Medicare Coordination of Benefits System.
To view the teleconference dates and agendas, please click here.
To view the companion document for the HIPAA Guidelines for Electronic Transactions, please click here. |
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CMS Releases Reference Guide for Section 111 Registration |
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Industry News Updates
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Written by Tom Matson
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Thursday, 21 May 2009 12:50 |
On May 8, 2009, The Centers for Medicare and Medicaid Services (CMS) released a quick reference guide for Section 111 registration for all Responsible Reporting Entities (RREs). Included within this guide are examples of issues a registrant may encounter when trying to register, such as how to obtain an RRE ID number, and how to register multiple RRE IDs.
Also included with this reference guide are useful web links to Section 111 Mandatory Insurer Reporting pages within the CMS website.
To view this guide, please click here. |
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CMS Updates Section 111 Implementation Timeline |
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Industry News Updates
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Written by Tom Matson
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Thursday, 14 May 2009 12:39 |
On May 11, 2009, The Centers for Medicare and Medicaid Services (CMS) announced several changes relating to Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA). These changes include an update to the implementation timeline, as well as updates on reporting thresholds for Total Payment Obligations to Claimants, or TPOCs.
With the release of this memo, the registration period for liability insurance (including self-insurance, no-fault insurance, and workers’ compensation RREs) has been extended. RREs now have from May 1, 2009 through September 30, 2009 to register. Consequently the testing period will now take place from January 1, 2010 through March 31, 2010, with first live files now scheduled to be submitted in the April-June quarter of 2010.
There have also been some changes relating to the TPOCs. The CMS has now determined that the Section 111 reporting will not include the reporting of TPOC amounts with dates prior to January 1, 2010. If a TPOC amount dated on or after January 1, 2010 falls below the threshold amount, the RRE is to add all associated TPOC amounts dated on or after January 1, 2010 in determining if the reporting threshold is met. Any associated TPOC amount occurring prior to January 1, 2010 should not be considered when calculating the TPOC amount for purposes of the reporting threshold. However, The CMS has also stated within this memo that although RREs are not required to report TPOCs where the applicable TPOC date is prior to January 1, 2010, a record will not be rejected based upon a TPOC date before January 1, 2010.
To view this memo in its entirety, please click here. |
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Treasury Predicts Medicare Shortfall By 2017 |
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Industry News Updates
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Written by Tom Matson
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Wednesday, 13 May 2009 08:42 |
On Tuesday May 12, 2009, officials who oversee the Social Security trust fund announced that they now foresee a Medicare shortfall by 2017, two years earlier than was predicted just last year. This same report also predicts a Social Security exhaustion by 2037, which is actually four years earlier than was predicted last year.
Officials went on to state that the main reason for the change in the forecast is the demand for benefits have increased while money paid in has decreased. The increase in benefits has been attributed to growing unemployment and new tax breaks in the economic stimulus package that was passed earlier this year.
The release of this report gives a clear indication as to why the Center for Medicare and Medicaid Services (CMS) will require mandatory insurer reporting. It has become increasingly evident that the stress currently placed on our Social Security and Medicare systems by recent economic developments has brought about the need for this change.
To view this report in its entirety, please click here. |
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CMS Further Clarifies “Delete Record” Issues |
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Industry News Updates
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Written by Tom Matson
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Monday, 27 April 2009 00:00 |
CMS has attempted to further clarify some of the issues surrounding the pending reporting requirements set forth in Section 111 of the MMSEA. These new clarifications have undoubtedly resulted from issues raised during the registration and testing period for GHP RREs, which began earlier this month.
First of all CMS has brought attention to Deleting Records. They have updated their website to stress that the “Delete Record” function should ONLY be used for the following circumstances:
1. To delete an entire record that was created in error.
For example, if a record was created and posted (you received a '01' disposition code in your MSP Response File) and it never should have been created, a Delete would be used to remove the record. CMS goes on to say that if you submitted a file in error but never received a “01”, than there is no need to submit a “Delete Record” for that file.
2. To correct one of the following key fields in a previously successfully added MSP record: Effective Date, Insurance Coverage Type, and Patient Relationship. In these cases the Delete should be followed by an Add transaction containing the correct information.
CMS goes on to say that if other information changes, (for example, Termination Date), than the RRE is to follow standard Update procedures. Additional updates today include the posting of the transcripts from the April 8, 2009 GHP Town Hall Meeting and the April 9, 2009 Non-GHP Town Hall Meeting. They have also added the COBSW link to their Overview section of the CMS website. To view these updates in their entirety, please click here. |
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