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**MMSEA ALERT** Additional Information Regarding MMSEA Changes 2/25/2010

CMS Provides Additional Guidance for the Implementation of MMSEA on January 1, 2011

MMSEA Section 111- CMS What’s New 02/25/2010: http://www.cms.hhs.gov/mandatoryinsrep/04_whats_new.asp?

February 25, 2010

The following documents are being posted to the NGHP section page:

  • NGHP User Guide, V3.0 dated February 22, 2010
  • Revised February 24, 2010 Notice and Agenda for 2010 Teleconferences for NGHP denoting new date for the cancelled February 10th call.

Live reporting for MMSEA Section 111 will take place on January 1, 2011. The 7/1/2009 reportable claims date has been retracted. The following 2010 settlements are now reportable:

  • October 1, 2010 (on or post): Lump sum awards
  • January 1, 2010 (on or post): Expected ORM (Ongoing Responsibility to Medical)

MMSEA Section 111- CMS Alert 02/24/2010:

http://www.cms.hhs.gov/MandatoryInsRep/09_Alerts.asp#TopOfPage

In order to be compliant with MMSEA Section 111 RRE’s must:

1) Register.

2) Engage in data exchange testing with the COBC.

3) Begins and continues regular data exchange with the COBC.

Compliant RRE Registration:

1) Completes the required registration process.

2) Contact the COBC informing them of the inability to register during the initial timeframe provided.

3) Resulting in late registration approved by CMS.

NOTE:

  • RRE’s that do not have claims to report are not required to register until further guidance has been provided by CMS once it has been established that the RRE has reportable claims.
  • Those RRE’s that have reasonable expectation of having claims to report must register in time to permit a full calendar quarter for testing prior to the submission of live files.

Compliant Data Testing:

1) Begin testing on schedule.

2) Successfully completes testing.

3) Informing the EDI rep. of any problems resulting in the extension of the testing cycle, that is approved by CMS.

4) Testing is complete with the approval of CMS and the COBC.

Compliant Reporting (live file submission):

1) Follows the routine file submission process. Failing to do say will result in the COBC contacting the RRE for explanation of the process for regular file submission on it’s designated schedule.

2) The RRE’s Claim Input File enables the COBC to successfully process the submitted data after an initial reporting cycle.

3) The RRE must consistently follow CMS data submission protocols while reporting, providing data that can be adequately processed and used.

Synergy can help you navigate the complicated and ever-changing MMSEA landscape. Contact us today to see how we can help you maintain compliance and achieve the best possible result for your client. (877)907-LIEN or info@synergysettlements.com.

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