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TXANS Association of Responsible Nonsubscribers

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Austin, TX 78701
Ph: 512-477-7357
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The Medicare, Medicaid and SCHIP Extension Act (the Act) applies to employers (both subscribing and nonsubscribing), insurance carriers, third party administrators, attorneys and more. The purpose of the Act and the related Medicare Secondary Payer (MSP) rule is to prevent employers, insurers and others from shifting financial responsibility for certain claims to the federal government.

While Medicare assumed the role of secondary payer for many years, the responsible payer was oftentimes identified long after the fact providing the federal government limited opportunity for recovery. To address this concern the Act now contains provisions that require significant up-front reporting obligations. Depending on the type of benefit plan, the obligation for reporting can rest on an employer, insurers and others.

On February 17th the Centers for Medicare and Medicaid Services (CMS) announced an extension of the reporting deadline for Responsible Reporting Entities (RREs). The original deadline of April 1, 2010 has now been extended to January 1, 2011.

Despite the change to the reporting deadline, RREs should keep in mind that any ongoing responsibilities entered into as of July 1, 2009 and any settlements or payments after January 1, 2010 are still subject to the reporting requirements. The delay only relates to the implementation of reporting.

Itís also important to note that the definition of an RRE has also changed. Depending on the type of insurance involved, the reporting responsibilities governed by the MSP rules may now become the responsibility of an insurer.

Additional Information

TXANS 20th Annual Nonsubscriber Conference & Exhibition will feature a Learning Lab on the Medicare Secondary Payer rules. Sue Maraglino, a Medicare Set-Aside Certified Consultant (MSCC) and Dallas attorney Chad Farrar, who has interfaced with the Centers for Medicare and Medicaid Services on behalf of Texas nonsubscribers, will lead this not-to-be-missed educational program. The program will focus in these newest changes along with a general review of the rules, what claims are eligible, what entities are affected and what steps are necessary to ensure compliance.

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