Tag Archives: #Section111

Section 111: What is Medicare missing?

Workers’ compensation and liability insurance carriers have the obligation to report two essential events if a claim involves a Medicare Beneficiary: Ongoing Responsibility for Medical (ORM) Settlement, judgment, award, or other payment Medicare refers to a settlement, judgment award, or other payment as “Total Payment Obligation to Claimant (TPOC).” These two events require the carrier/self-insured […]

CMS Issues Section 111 NGHP User Guide Version 6.0

The new Section 111 NGHP User Guide 6.0 (Guide) was issued by CMS on October 5, 2020 and contains several updates as noted below. Chapter III, Section 4.6 of the Guide, CMS has specified what items should be included when calculating the Total Payment Obligation to Claimant (TPOC).  CMS notes that the “TPOC amount includes, […]

CMS Provides Webinar: Section 111 Non-Group Health Plan (NGHP)

August 17, 2020 by Patrick Czuprynski  On 8/13/2020, CMS provided a webinar and PowerPoint presentation to highlight and refresh stakeholders regarding certain aspects of Section 111 reporting and the recommendations outlined in the MMSEA Section 111 User Guide. It is important to understand that CMS is using the carrier/self-insured (or their TPA) claims system reporting […]

Section 111 Non-Group Health Plan (NGHP) Reporting Webinar – Thursday, August 13, 2020

On Thursday, August 13, 2020, CMS will be hosting a webinar for Non-Group Health Plan (NGHP) Liability Insurance (including Self-Insurance) No-Fault and Workers’ Compensation Section 111 Reporting entities.  CMS will provide initial opening remarks followed by a presentation which will include best practice and reminders.  Questions for the webinar can be mailed to: Section 111 […]

CMS Issues New Section 111 Alert

Jun 12, 2020 by Bridget Smith, JD CMS Issues New Section 111 Alert for Reporting No-Fault Insurance Limit on Non-Group Health Plan (NGHP) Claim Input Files In this Alert dated June 8, 2020, CMS  reminds Non-Group Health Plan (NGHP) Responsible Reporting Entities (RREs)  that when reporting No-Fault Insurance Limits via Section 111 both Med Pay […]