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CMS releases updated Section 111 Model Language document

04/20/21
The Centers for Medicare and Medicaid Services has released an updated
PDF version) for RREs to use as part of their efforts to obtain certain data points, including a claimant s social security number or Medicare number, to assist in determining his or her Medicare beneficiary status. While CMS does not require RREs to use this Model Language document, in practice, many RREs utilize this document as part of their Section 111 data collection activities.
CMS s revised Model Language document dated March 10, 2021 updates the agency s prior version dated April 30, 2018. Overall, the updated Model Language document make various minor and non-substantive changes to the previous version. ....

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CMS Releases Updated Section 111 Model Language Document

04/19/21
The Centers for Medicare and Medicaid Services has released an updated
PDF version) for RREs to use as part of their efforts to obtain certain data points, including a claimant s social security number or Medicare number, to assist in determining his or her Medicare beneficiary status. While CMS does not require RREs to use this Model Language document, in practice, many RREs utilize this document as part of their Section 111 data collection activities.
CMS s revised Model Language document dated March 10, 2021 updates the agency s prior version dated April 30, 2018. Overall, the updated Model Language document make various minor and non-substantive changes to the previous version. ....

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PAID Act - Current Status and FAQs

03/12/21
Mark Popolizio, Kate Riordan, Jeremy Farquhar
A major Medicare secondary payer (MSP) watch-list item for 2021 continues to be how and when CMS will implement the Provide Accurate Information Directly (PAID) Act. Signed into law on December 11, 2020, the PAID Act will make changes to CMS s Section 111 Query Process. In general, under the PAID Act, CMS will be required to provide RREs with information regarding a claimant s Medicare Part C (Medicare Advantage) and Medicare Part D (prescription drug) enrollment status through the Section 111 Query Process.
At this time, the industry is waiting for CMS to release its PAID Act implementation plan, which will require yet to be released technical updates to its Section 111 Query Process. Thus, until CMS provides more information, RREs remain in a holding pattern regarding what technical updates may be necessary. ....

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CMS to host BCRC and CRC NGHP town hall on April 1st

03/03/21
The Centers for Medicare and Medicaid Services (CMS) has released a
notice announcing that it will be holding a Benefits Coordination & Recovery Center (BCRC) and Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) town hall on April 1, 2021, at 1:00 p.m. ET.
Per CMS s notice, this town hall will “discuss common NGHP topics” and indicates that the panel will entertain questions regarding Section 111 reporting and NGHP recovery issues.
CMS s notice states as follows:
CMS will be hosting a town hall to discuss common NGHP topics. During this town hall, staff from CMS, the BCRC and the CRC will all be on hand to answer your NGHP related questions. Whether you have questions about Section 111 reporting or about NGHP recovery, this town hall will be beneficial. Questions for this town hall can be submitted in advance to ....

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CMS Releases New NGHP Section 111 User Guide (Version 6.2, January 11, 2021)

01/26/21
The Centers for Medicare and Medicaid Services (CMS) has released an updated
As usual, CMS lists its updates at the beginning of each User Guide chapter on a “Summary” page. Reviewing these pages indicates that CMS has made updates to Chapter II (Registration Procedures), Chapter III (Policy Guidance), Chapter IV (Technical Guidance), and Chapter V (Appendices). Overall, CMS made various changes to its Section 111 reporting directives, most notably making Policy Number (Field 54) a key field and expanding ORM termination dates up to 75 years. Also, CMS issued a retraction regarding one item addressed in its prior Version 6.1 update.
The following provides a general overview of the updates made by CMS in User Guide (Version 6.2): ....

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