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MMSEA Section 1111 Update

The Centers for Medicare & Medicaid Services (CMS) has recently updated the information on its website with respect to the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA), Section 111 “Mandatory Insurer Reporting” requirements.

The next phase of CMS’ MMSEA Section 111 reporting for liability Total Payment Obligation to Claimants (TPOCs) including settlements, judgments, awards, or other payments now begin on April 1, 2012.  Starting April 1, 2012, the liability TPOC reporting threshold will be reduced from $100,000 to $50,000. More importantly all liability TPOCs greater than $50,000 for TOPCs on or after April 2st through Jun 30th will no be reportable.

They are also scheduled to reset again on July 1, 2012 to October 1, 2012.

The new implementation dates are as follows:

Reporting is required October 1, 2011 to March 31, 2012  for TPOCs over $100,000
Reporting is required April 1, 2012 to June 30, 2012  TPOCs over $50,000
Reporting is required July1 , 2012 to September 30, 2012 TPOCs over $25,000
Reporting is required October 1, 2012 to Dec 31, 2012  for all TPOCs over $5000
Starting in 2015 no threshold amount

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