MMSEA111 - Future Town Hall Teleconference Dates - All town hall teleconferences are held from 1:00pm to 3:00pm EST, unless otherwise noted.

October 27, 2009

November 16, 2009

December 10, 2009                         

New Section 111 Provisions For GHP Arrangements, found at U.S.C. 1395y(b)(7)

Section 111 adds reporting rules; it does not eliminate any existing statutory provisions or regulations.

• It includes penalties for non-compliance.
• It includes provisions for the Secretary to share information on Part A entitlement and enrollment under Part B.
• Who Must Report: "an entity serving as an insurer or third party administrator for a group health plan...and, in the case of a group health plan that is self-insured and self-administered, a plan administrator or fiduciary."
• What Must Be Reported:  Data elements determined by the Secretary.
• A voluntary GHP insurer reporting process is already in place.  The mandatory reporting process will build upon the existing voluntary process.
• When/How reporting must be done:
  • In a form and manner, including frequency, specified by the Secretary.
  • GHP reporting will be no more than quarterly.
  • Submission will be in an electronic format.

• Use of Agents: GHP RREs may use agents to submit data on their behalf. An agent is a data services company, consulting company, or the like that can create and submit Section 111 files to the COBC on behalf of the RRE. Information on the use of agents is required as part of the Section 111 registration process. The RRE remains solely responsible and accountable for adhering to the requirements of the Section 111 program and for the accuracy of data submitted.

Downloads
Revised September 16, 2009 - GHP Notice and Agenda For Remaining Teleconferences in 2009 [PDF 37.6KB] Updated MMSEA 111 - Revised - September 24, 2009 - 270/271 Health Care Eligibility Benefit Inquiry and Response; HIPAA Guidelines for Electronic Transactions - Companion Document for Mandatory Reporting GHP Entities [PDF 308, KB] MMSEA - Revised - May 22, 2009 - GHP User Guide Version 2.3 [PDF 986KB] MMSEA 111 - May 8, 2009 - Quick Reference Guide for Section 111 Registration For All Responsible Reporting Entities [PDF 246KB] ALERT - April 6, 2009 - MMSEA Section 111 GHP RRE Registration: Coordination of Benefits Secure Website (COBSW) Version 2 [PDF 26.7KB] ALERT - January 8, 2009 - Section 111 Reporting Involving Group Health Plan Small Employer Exception (SEE) Request Information [PDF 37.6KB] MMSEA111 - December 16, 2008 - GHP Responsible Reporting Entities Compliance Document [PDF 30.4KB] September 25, 2008 - GHP Data Elements [PDF 51KB] September 22, 2008 - GHP - Employer Size vs Covered Lives and Small Employer Exception [PDF 53KB]
Related Links Inside CMS
Coordination of Benefits Secure Website
Related Links Outside CMS
There are no Related Links Outside CMS

Page Last Modified: 09/29/2009 1:49:40 PM
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