2010 Town Hall Teleconference Dates - All town hall teleconferences are held from 1:00pm to 3:00pm EST unless otherwise noted.  Call in information is provided in the document titled "Notice and Agenda For 2010 Teleconferences for NGHP" located in the Downloads section of this section page.       

NGHP Technical Support Question & Answer   

• March 11- Reschedule date for the cancelled February 10th call due to inclement weather.  Please refer to the Revised Notice and Agenda for 2010 Teleconferences for NGHP for the new call in number for this call only.
• March 31

NGHP Policy Question & Answer  

• February 25
• March 16 

New Provisions For Liability Insurance (including Self-Insurance), No-Fault Insurance and Workers' Compensation, found at 42. U.S.C. 1395y(b)(8)

Section 111 adds reporting rules; it does not eliminate any existing statutory provisions or regulations.

The new provisions do not eliminate CMS' existing processes if a Medicare beneficiary (or his/her representative) wishes to obtain interim conditional payment amount information prior to a settlement, judgment, award, or other payment.

• It includes penalties for noncompliance.
• Who Must Report:  "an applicable plan." , "...[T]he term 'applicable plan' means the following laws, plans, or other arrangements, including the fiduciary or administrator for such law, plan, or arrangement: (i) Liability insurance (including self-insurance). (ii) No fault insurance. (iii) workers' compensation laws or plans."
• What Must Be Reported:  The identity of a Medicare beneficiary whose illness, injury, incident, or accident was at issue as well as such other information specified by the Secretary to enable an appropriate determination concerning coordination of benefits, including any applicable recovery claim.
• Data elements determined by the Secretary.
• When/How Reporting Must be Done:
  • In a form and manner, including frequency, specified by the Secretary.
  • Information shall be submitted within a time specified by the Secretary after the claim is resolved through a settlement, judgment, award, or other payment (regardless of whether or not there is a determination or admission of liability).
• Submissions will be in an electronic format. 

• Use of Agents: The applicable NGHP RRE may contract with an entity to act as an agent for reporting purposes. Agents may include, but are not limited to, data service companies, consulting companies or similar entities that can create and submit Section 111 files to the COBC on behalf of the RRE. An RRE may not shift its Section 111 reporting responsibility to an agent, by contract or otherwise.  The RRE remains solely responsible and accountable for complying with CMS instructions for implementing Section 111 and for the accuracy of data submitted.

Downloads
Revised MMSEA 111 - February, 2010 - 270/271 Health Care Eligibility Benefit Inquiry and Response Companion Guide fro NGHP Entities, Version 4.0 [PDF 339KB] Revised - February 24, 2010 - MSEA 111 - December 29, 2009 - Notice and Agenda For 2010 Teleconferences For NGHP [PDF 39.1KB] MMSEA 111 - February 22, 2010 - User Guide - Liability Insurance (including Self-Insurance), No-Fault Insurance and Workers' Compensation User Guide, Version 3.0 [PDF 1.3MB] MMSEA 111 - June 9, 2009 Teleconference Transcript [PDF 194KB] MMSEA 111 - June 2, 2009 Teleconference Transcript [PDF 189KB] MMSEA 111 - May 14, 2009 Teleconference - Transcript [PDF 179KB] MMSEA 111 - ALERT - May 11, 2009 - NGHP Version 1.0 User Guide Supplement [PDF 188 KB] MMSEA 111 - May 8, 2009 - Quick Reference Guide for Section 111 Registration For All Responsible Reporting Entities [PDF 246KB] MMSEA111- April 7, 2009 - Alert For Reporting Multiple Total Payment Obligation to the Claimant (TPOC) Amounts [PDF 157KB] MMSEA 111 - March 20, 2009 - Alert for Liability Insurance (Including Self_Insurance), No-Fault Insurance, and Workers' Compensation - [PDF 48KB]
Related Links Inside CMS
MMSEA111 - August 18, 2009 - Audio - Transcript - NGHP Teleconference - Part 1 [MP3 90.0 MB] MMSEA111 - August 18, 2009 - Audio - Transcript - NGHP Teleconference - Part 2 [MP3 90.0 MB] MMSEA111 - August 11, 2009 - Audio - Transcript - NGHP Teleconference - Part 1 [MP3 90.2MB] MMSEA111 - August 11, 2009 - Audio - Transcript - NGHP Teleconference - Part 2 [MP3 45.9MB] MMSEA111 - February 25, 2009 - Audio - Transcript - NGHP Teleconference Part 1 [MP3 93.4MB] MMSEA111 - February 25, 2009 - Audio - Transcript - NGHP Teleconference Part 2 [MP3 46.4MB] MMSEA111 - January 28, 2009 - Audio - Transcript - NGHP Teleconference Part 1 [MP3 90.7MB] MMSEA111 - January 28, 2009 - Audio - Transcript - NGHP Teleconference - Part 2 [MP3 41.7MB] MMSEA111 - January 22, 2009 - Audio - Transcript - NGHP Teleconference Part 1 [MP3 89.4MB] MMSEA111 - January 22, 2009 - Audio - Transcript NGHP Teleconference Part 2 [MP3 24.9MB]
Related Links Outside CMS
There are no Related Links Outside CMS

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