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CMS Revises Mandatory Insurer Reporting Implementation Timetable

 

On June 20, 2012, the Centers for Medicare and Medicaid Services issued three alerts revising the implementation timetable for the Medicare Secondary Payer (MSP) Mandatory Insurer Reporting (MIR) requirements.

The implementation timetable for liability TPOCs was revised as follows:

 

Mandatory Thresholds for Liability Insurance (including self-insurance) TPOC Settlements, Judgments, Awards or Other Payments

Total TPOC Amount TPOC Date On or After Section 111 Reporting
Required in the Quarter
Beginning
TPOCs over $100,000 October 1, 2011 January 1, 2012
TPOCs over $50,000 April 1, 2012 July 1, 2012
TPOCs over $25,000 July 1, 2012 October 1, 2012
TPOCs over $5,000 October 1, 2012 January 1, 2013
TPOCs over $2,000 October 1, 2013 January 1, 2014
TPOCs over $300 October 1, 2014 January 1, 2015

 

The implementation timetable for workers compensation TPOCs was revised as follows:

 

Mandatory Thresholds for Workers’ Compensation
TPOC Settlements, Judgments, Awards or Other Payments

Total TPOC Amount TPOC Date On or After Section 111 Reporting
Required in the Quarter
Beginning
TPOCs over $5,000 October 1, 2010 January 1, 2011
TPOCs over $2,000 October 1, 2013 January 1, 2014
TPOCs over $300 October 1, 2014 January 1, 2015

 

In addition, the mandatory minimum dollar threshold for workers’ compensation Ongoing Responsibility for Medicals (ORMs) for “medicals only” claims of $750 or less was extended indefinitely.  Previously this exemption expired on 12/31/2012.

It is important to note from that, beginning July 1, 2012, liability insurance TPOCs over $50,000 must be reported.

To view all three June 20, 2012 CMS Alerts click here.

 

 

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