MRC offers a suite of services to companies subject to Mandatory Insurer Reporting under Section 111 of the Medicare, Medicaid and SCHIP Extension Act (MMSEA Section111). MRC provides assistance through the registration and testing process as a CMS reporting agent, or in collecting the necessary data in the prescribed format for clients to submit directly to CMS.
The following are offered as stand-alone services, or may be combined for a comprehensive solution:
- CMS Reporting Agent: MRC offers a full reporting agent service. This is an end-to-end process that includes Medicare eligibility verification through the CMS query system, data collection, and timely and accurate reporting
- Completion of Responsible Reporting Entity (RRE) registration on behalf of an RRE
- Development and implementation of CMS-required data file submission on behalf of RRE
- Management of CMS data exchange for settlement reporting
- Collection and capture of CMS-required data points and/or ICD-9 codes into custom fields
- Opposing Counsel Services: MRC will identify any incomplete data fields and/or missing authorizations and resolve missing data by coordinating communications directly with the claimant’s attorney
Who is subject to these new regulations?
In general, an entity is considered a Responsible Reporting Entity (RRE), if it funds and pays for a settlement, judgment or award to a Medicare beneficiary. Under MMSEA Section 111 RREs are required to report over 100 data points for every Medicare eligible claimant, including up to 19 ICD-9 codes. The costs for non-compliance are substantial. See MRC’s blog, The WiseFiles, for a series of posts on MMSEA reporting.
Other resources:
- MRC Clients: Please note that MMSEA Query Forms, Settlement Data Forms, and Consent to Release Forms are now available by request. Contact your Project Manager for details.
- Click here for the most updated list of ICD-9 codes (version 28).
- Click here for the most up to date MMSEA Section 111 information from the CMS website.