CMS - Restrictions on Additional File Submissions Lifted

Post date: May 03, 2012 1:18:23 PM

May 1, 2012

Medicare Secondary Payer Mandatory Reporting Provisions in

 Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007

Restrictions on Additional File Submissions Lifted for Liability Insurance

(Including Self- Insurance), No-Fau lt  Insurance,  and  Workers’  Compensation


As of the date of this Alert, restrictions that previously limited Section 111 Non-GHP (NGHP) RREs to submitting one Claim File per quarter have been lifted.  NGHP RREs maynow submit multiple files within a single quarter.  The primary purpose of additional file submissions is to provide NGHP RREs with an opportunity to expediently post updates to existing records, such as when an RRE’s Ongoing Responsibility for Medicals (ORM) has terminated.  NGHP RREs will now have the ability to provide timely ORM termination dates via their standard electronic submission process.


There are two limitations that apply to this change:

Standard quarterly file submissions are still mandated during the NGHP RRE’s assigned file submission period. There is no requirement for NGHP RREs to submit more than onefile per quarter.


The content of this ALERT supersedes the content of the existing User Guide (Version 3.3) and will be incorporated into the next version of the User Guide.