Legislative Updates

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Medicare Secondary Payer Updates

Posted by Genex on November 27, 2019

Keep current with new legislation and its potential effect on your organization. This regulatory update is for informational purposes only, and provides some key highlights on state initiatives that may impact the Medicare Set-Aside services Genex provides.

Miscellaneous Medicare Secondary Payer Clarifications and a Reminder for Non-Group Health Plan (NGHP) Responsible Reporting Entities (RREs) Regarding Medicare Beneficiary Identifier (MBI) Reporting

The Centers for Medicare and Medicaid Services (CMS) have once again pushed back the date for rolling out Notice of Proposed Rulemaking to address future medical obligations in liability and no-fault matters.  This proposed rule would ensure that beneficiaries are making the best healthcare choices possible by providing them and their representatives with the opportunity to select an option for meeting future medical obligations that fits their individual circumstances, while also protecting the Medicare Trust Fund. According to the Office of Information and Regulatory Affairs website (reginfo.gov) the timetable for release of Miscellaneous Medicare Secondary Payer Clarifications and Updates is scheduled for February 2020. Genex will continue to monitor CMS’ proposed options for addressing future medical obligations will keep you informed.

In other Medicare news, on November 18, 2019 CMS issued an important reminder for Non-Group Health Plan (NGHP) Responsible Reporting Entities (RREs) regarding the reporting of the Medicare Beneficiary Identifier (MBI). As you will recall the MBI replaces the discontinued Social Security Number (SSN)-based Medicare identifier (also known Health Insurance Claim Number (HICN)). This replacement was required by Section 501 of the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act (MACRA) of 2015. The 21 month MBI transition period will end on December 31, 2019.

Per the Alert, Section 111 Medicare, Medicaid and SCHIP Extension Act (MMSEA) NGHP RREs are not required to resubmit Section 111 Claim Input records with an MBI where they previously reported using the beneficiary’s HICN.  If the RRE wants to update their Section 111 Claim Input records with an MBI they should do so by sending an updated record with the MBI as the Injured Party Medicare ID. RREs should not delete and re-add a previously submitted record to update to the MBI.

Any questions should be directed to the RREs’ assigned Electronic Data Interchange (EDI) Representative at the Benefits Coordination & Recovery Center (BCRC).

To view the alert in its entirety click here

For more information/questions about Miscellaneous Medicare Secondary Payer Clarifications, Medicare Beneficiary Identifier reporting or to make a referral please call 1. 888.GO.GENEX or send an email to msadirect@genexservices.com


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