CMS Issues Alert With a Reminder for Non-Group Health Plan Responsible Reporting Entities

Mandatory Insurer Reporting, Medicare, Medicare Set-Aside Blog, MSP News on November 22, 2019
Posted by Jean S. Goldstein, JD, CMSP

While the big news of this week was that the proposed rulemaking due dates for both the rule concerning civil money penalty provisions for Medicare Secondary Payer (MSP) reporting and the rule to address satisfying MSP obligations has been extended once again, CMS also issued an alert this week with an important reminder for Non-Group Health Plans Responsible Reporting Entities (RREs).  The alert concerns the use of Medicare Beneficiary Identifiers (MBIs), which came about as the result of the passage of the Medicare Access and CHIP Reauthorization Act of 2015, which mandated the removal of the Social Security Number based Health Insurance Claim Number (HICN) from Medicare cards.

The alert reminds RREs that they are not required to resubmit Section 111 claim input records with a Medicare Beneficiary Identifier (MBI) previously reported with a HICN.  RREs wishing to update their Section 111 Claim Input records with an MBI should do so by sending an update record with the MBI as the Injured Party Medicare ID.  RREs should not delete and re-add a previously submitted record to update to the MBI.

Any questions should be directed to the RREs’ assigned Electronic Data Interchange (EDI) Representative at the Benefits Coordination & Recovery Center (BCRC).