CMS Issues Updated Section 111 User Guide and Updated WCMSA Portal User Guide

CMS, Mandatory Insurer Reporting, Medicare Set-Asides on July 19, 2019
Posted by Jean S. Goldstein, JD, CMSP

The Centers for Medicare and Medicaid Services (CMS) released two new updated guides earlier this month: an updated Section 111 Medicare Secondary Payer Reporting User Guide, and an updated Workers’ Compensation Medicare Set-Aside Portal User Guide.  Both of these guides contain very minor updates, which will not have a significant impact on the claims handling process.  As with all CMS updated guides, changes and updates are found in the beginning of each guide, or as in the Section 111 User Guide at the beginning of each chapter (if changes have been made).  The updates are as follows:

MMSEA Section 111 User Guide, Version 5.6, July 1, 2019

Chapter II (Registration Procedures), Section 4.2.2: CMS has added clarification that Responsible Reporting Entities (RRE) should submit one Claim Input file per quarter.  However, also noted in the guide, is mention that CMS will still accept multiple Claim Input Files per quarter.

Chapter IV (Technical Information), Section 8.2 and 8.4: The retention period for downloading response files has been updated from 180 days to 60 days. RREs can download the latest PC/server version of the HIPAA Eligibility Wrapper (HEW) software from the Section 111 MRA application, which is compatible with Windows 10 (also noted in Chapter V.)

Workers’ Compensation Medicare Set-Aside Portal (WCMSAP) User Guide Version 5.8, July 1, 2019

In order to assist Account Managers (AMs) with designee-limit tracking and the identification of inactive accounts, the Total Number of Account Designees has been added, and AMs can now sort and filter Account Designees (ADs) by Last Login Date, Last Name, and Status fields on the Designee Listing page (Chapter 9) in the WCMSAP. AMs can now also add up to 200 ADs to a corporate account (Section 2.3.3).

As mentioned, the changes in both of these guides are very minor and should not impact daily claims handling.