NU Online News Service, Nov. 15, 3:30 p.m. EST
The Centers for Medicare and Medicaid Services has agreed to delay until January 2012 certain mandatory reporting requirements for certain liability claims.
The exemption will be for liability claims that do not involve on-going medical responsibility, according to officials at the American Insurance Association.
The law was passed in 2007 in order to ensure that Medicare remains the secondary payer when a Medicare beneficiary has medical expenses that fall under the primary responsibility of a liability, no-fault, or workers' comp insurance plan (including those that are self-insured).
Under the law, Medicare can recover any conditional payments it has made that should have been paid by the primary insurance plan.
The issue is important for property and casualty insurers and self-insured risk managers of major businesses.
Earlier, CMS had postponed reporting mandates under the bill from last April to January 2011.
AIA has been negotiating for the delay since September, when it wrote a letter to the parent Department of Health and Human Services requesting a specific delay for liability claims that do not involve on-going medical responsibility. This is a unique niche of liability claims for which little guidance has yet been issued, said Peter Foley, AIA's vice president for claims administration and chair of AIA's MSP task force.
"We are pleased that CMS decided to push back the reporting deadline again until more specific guidelines can be provided on several outstanding issues," Mr. Foley said in a statement. "The insurance industry will comply with the requirements, but complete and correct information is needed so that the industry's data can be assembled in the most useful way possible for CMS."
Mr. Foley said the industry welcomes CMS's recognition that there is "need for serious and continued dialogue on the many issues that are still unresolved in the application of Section 111 to these claims."
He added, "AIA remains committed to working with CMS to successfully implement Section 111′s reporting requirements for the difficult and unique context of liability claims."
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