MMSEA Section 111 Alert: CMS to Allow NGHP RREs to Designate a Medicare Secondary Payer Recovery Agent through Mandatory Insurer Reporting, July 2015

CMS, Medicare Set-Aside Blog, MSP News on November 14, 2014 | Posted by Jessica M. Wingenroth, JD

The current “TPA workaround” method of identifying a third party administrator on TIN Reference files is being eliminated. CMS has announced that effective 07/13/15, NGHP RREs will have the option to designate an MSP Recovery Agent with whom they wish to share copies of all correspondence related to conditional payments and recovery demands. The RRE will also continue to receive recovery correspondence directly.

If an RRE chooses to name a Recovery Agent, the agent’s name and address may be provided on the TIN Reference File in new fields 16-22. CMS will accept entry of the Recovery Agent’s information as authorization for the agent to act on behalf of the RRE in the resolution of any recovery-related claims, and the RRE will be bound by the designated Recovery Agent’s actions. As is always the case, CMS reminds us that the RRE remains ultimately responsible for adhering to all MSP obligations and requirements.

The full Alert can be found here: http://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Mandatory-Insurer-Reporting-For-Non-Group-Health-Plans/Downloads/New-Downloads/Technical-Alert-Option-for-RREs-to-Submit-Recovery-Agent-Information-for-MSP-Recovery-Related-Correspondence-.pdf