Cms Section 111

The purpose of section 111 reporting is to enable cms to pay appropriately for medicare covered items and services furnished to medicare beneficiaries.

Cms section 111. The purpose of the section 111 reporting process is to enable the centers for medicare medicaid services cms to pay appropriately for medicare covered items and services furnished to medicare beneficiaries by determining primary versus secondary payer responsibility. The responsible reporting entity rre and its duly authorized agent for this section 111 reporting if any shall establish appropriate administrative technical procedural and physical safeguards to protect the confidentiality of the data and to prevent unauthorized access to the data provided by cms. In general cms s proposals are aimed at implementing the section 111 penalty provision which allows cms to impose cmps against nghp rres of up to 1 000 for each day of noncompliance with respect to each claimant.

On a quarterly basis an rre must submit a file of information about employees and dependents who are medicare beneficiaries with employer ghp coverage that may be primary to medicare. Section 111 authorizes cms and ghp rres to electronically exchange health insurance benefit entitlement information. United states department of health and human services.

Section 111 reporting facilitates the centers for medicare medicaid services cms recovery of past medical expenses what are called conditional payments in msp regulations or its refusal to pay future medical costs of medicare beneficiaries who receive nghp or ghp payments for the same bodily injuries or emotional distress. Re post february 23 2009 introduction to section 111 mandatory medicare secondary payer reporting pdf home a federal government website managed and paid for by the u s.