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In December of 2007, Congress enacted Section 111 of the Medicare, Medicaid & SCHIP Extension Act, which mandates that insurers and self-insureds participate in an automated exchange of medical claims and settlement data. The provision provides Medicare with all the data needed to enforce compliance not only with Section 111 but also with the Medicare Secondary Payer (MSP) statute, a law requiring that Medicare not pay for medical treatment when another primary payer is available.

Now, more than four years later, the Centers for Medicare & Medicaid Services (CMS) has nearly finished implementing the mandatory reporting in stages. Workers’ Comp and no-fault claims started reporting in January 2011. In January 2012, CMS began to require that all liability settlements involving Medicare beneficiaries also be reported, subject to certain thresholds.

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