Utah Bar Journal

Section 111 of the MMSEA Imposes Significant New Penalties for Failing to Protect Medicare’s Interests

by Mark Popolizio and Carrie T. Taylor

The following serves as an “update” to the information contained in an article published in the Utah Bar Journal, January, 2009, Vol. 22, No. 1.

As noted in the article, the Center for Medicare & Medicaid (CMS) is currently in the process of releasing its Mandatory Insurer Reporting (MIR) guidelines to implement the provisions of Section 111 of the Medicare, Medicaid & SCHIP Extension Act (MMSEA).

Subsequent to the preparation of the January article, CMS released its “Revised” Interim Record Layout (12/5/08 Version). In addition, CMS held its fourth national “Town Hall” teleconference on January 22, 2009, which was followed by a “Question and Answer” session on January 28, 2009. CMS released this information in relation to Section 111 compliance regarding “liability insurance (including self-insurance), no-fault insurance and workers’ compensation,” which is collectively referred to under the MIR as “Non-Group Health Plans” (non-GHP or NGHP).