ANPRM for MMSEA Section 111 Reporting Released

CMS, Medicare Set-Aside Blog on December 11, 2013
Posted by Jennifer Jordan, JD, MSCC

In the December 11, 2013 Federal Register, CMS finally requested public comments for implementation of mandatory insurer reporting penalty provisions as required by the SMART Act enacted on January 10, 2013, only nine months and one day later than the statute mandated. Unlike the ANPRM for liability Medicare set-asides, CMS did not make any suggestions and instead outlined the methods that it is requesting proposals for, which are as follows:

  • Practices for which civil monetary penalties would or would not be imposed on GHPs and NGHPs, including criteria and/or mechanisms CMS may use to evaluate whether and when it would impose them.
  • Methods to determine the dollar amounts for penalties to be levied against a NGHP RRE for non-compliance.
  • Definitions and criteria that constitute “good faith effort” by NGHPs to identify a Medicare beneficiary for the purposes of reporting.

CMS will accept comments on the proposed rule until February 10, 2014. For more information, see: