CMS has released a Proposed Rule specifying how and when it must impose penalties on responsible reporting entities (RREs) that fail to meet their Section 111 reporting obligations. Here are the highlights:
CMS issued an Alert on November 15, 2016, concerning 2017 Recovery Thresholds. On December 12, 2016, it issued another Alert regarding 2017 Reporting Thresholds. CMS also updated its NGHP User Guide on January 3, 2017.
The effect of the Alerts:
Reporting Threshold: $750.00 for liability insurance (including self-insurance), no-fault insurance, and workers’ compensation payments.
Historically, the Benefits Coordination and Recovery Center (“BCRC”) arm of the Centers for Medicare & Medicaid Services (“CMS”) collected Medicare’s conditional payments. While the BCRC continues to address Medicare’s reimbursement rights with Medicare beneficiaries, in late 2015 the CMS’s Commercial Repayment Center (“CRC”) took over responsibility for seeking reimbursement directly from Applicable Plans. Applicable Plans