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:

  • The Proposed Rule indicates that the maximum penalty of $1,000.00 per day per claimant would be adjusted annually for inflation.  So for 2020, the maximum potential penalty would be $1,232.00 per day per claimant.
  • The Proposed Rule outlines various situations in which penalties would and would not be imposed against Non-Group Health Plan (NGHP) RREs.  It calls for penalties to be imposed when the RRE “fails to report any beneficiary record within 1 year from the date of the settlement, judgment, award, or other payment.”

The Proposed Rule is scheduled to be published in the Federal Register on February 18, 2020.  It is available here.