To download a pdf of this advisory, please click here.
Last week The Garretson Resolution Group, Inc. (GRG) released a client advisory regarding the Center for Medicare and Medicaid Services' (CMS) extension of the first settlement reporting date from April 1, 2010 to January 1, 2011. This delay effectively gives the defendants/insurers (a/k/a Responsible Reporting Entities or RREs) an additional nine months to ready themselves. As we mentioned in last week’s bulletin, the obligation to report settlements with Medicare beneficiaries is not going away; it is merely being delayed for nine months.
We also mentioned that CMS was going to provide information this week that would clarify whether defendants are still expected to request data from plaintiffs at the time of settlement for settlements occurring in 2010 (i.e. will settlements occurring during 2010 be reportable when defendants/insurers begin reporting in January of 2011). CMS issued three Alerts today which provide additional insight into the new reporting requirements. The following settlements occurring in 2010 will be reportable when the system goes live on January 1, 2011:
1. For lump sum awards, settlements on or after October 1, 2010 will be reportable;
2. For cases that were open on or after January 1, 2010 where the reporting entity has assumed ongoing responsibility to pay medical expenses (applies mainly to workers' compensation).
CMS has also stated that Version 3.0 of the User Guide has been approved for posting on their website, but has not been posted as of the time this advisory was published. The three Alerts are in addition to the User Guide, so the User Guide and all Alerts need to be reviewed to capture the new provisions. We will follow up to provide a complete update of the reporting provisions after the new version is released.
Other notable items from the Alerts include:
• In the CMS Alert titled Who Must Report, CMS clarifies who the reporting entity is in many circumstances, such as, deductible programs, self insured retention programs, bankruptcy; fronted policies, multiple defendants, and self Insurance pools. Additional information related to these will be forthcoming from GRG.
• CMS will issue an alert shortly which will provide guidance for foreign entities that do not have tax identification numbers or U.S. addresses. CMS stated in the town hall call today that these entities will be able to register on the Medicare website as of April 5, 2010. They will be able to use their foreign addresses and they will register with a unique ID number.
• CMS stated in the town hall call today, that they have not included guidance protocols for mass tort cases or on clinical trials. They gave no date for providing this guidance, although we are in regular contact with CMS related to multiple mass tort settlement programs in which we are serving as the Lien Resolution Administrator and will provide information related to such programs as soon as we receive it.
Please click here to find the guidance published by CMS.
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