CMS releases Section 111 Quick Reference Guide

CMS has issued an MMSEA Section 111 Mandatory Insurer Reporting Quick Reference Guide for non-GHP Insurers. The guide has been developed to provide the following:

  • Explaination of MMSEA Section 111 reporting, and how it may affect you
  • Help in determine if you are an MMSEA Section 111 “Responsible Reporting Entity” (RRE)
  • An overview on how to set up and begin reporting
  • Description of the various options you have for reporting
  • An outline of the data “input and response” process
  • Help in identifying resources for additional instruction and information on how to access free computer based training and other resources

The Quick Reference Guide is available here.

Smith v. Sound Breeze Condo Association of Groton

Smith v. Sound Breeze Condo Ass’n of Groton
No. KNLCV 095012261s, 2011 WL 803067
(Ct. Sup. Ct., Feb. 3, 2011)

In this case, the RRE requested permission to file a set of non-standard interrogatories to obtain the plaintiff’s name, address, social security number, birth date and gender so that it could determine Medicare status for Section 111 purposes.

However, the plaintiff objected on grounds that (a) the plaintiff was a not a Medicare beneficiary and, thus, the request was outside the scope of permissible discovery; (b) the request was overly broad and aimed at procuring non-discoverable private information; and (c) that the request was premature for Section 111 purposes.

The court rejected all of the plaintiff’s arguments and ruled that the requested information was relevant and ordered the plaintiff to produce same. Recognizing the plaintiff’s privacy concerns, the court also included a protective order as part of its ruling restricting the RRE’s use of this information solely for Section 111 compliance purposes.

Seger v. Tank Connection LLC

Seger v. Tank Connection LLC,
8:08 CV 75,
2010 WL 16652353
(D. NE., April 22, 2010)

In this case, the Responsible Reporting Entity (RRE) requested that the plaintiff produce his social security number and other information so the RRE could use the Section 111 Query Process system to determine Medicare status. However, the plaintiff refused to provide this information citing privacy and other concerns.

The court ordered the plaintiff to release his social security number and the other information requested by the RRE. In reaching its decision, the court found that the requested information was relevant and permissible under applicable federal discovery rules in light of the new reporting mandates imposed under Section 111.