Health Law Checkup - October 14, 2011
CMS Issues New Guidance for Medicare Secondary Payor Reporting


Medicare is a secondary payor to group health plans, liability insurance, no fault insurance and workers' compensation. The Medicare, Medicaid and State Children's Health Insurance Program Extension Act of 2007 (Act) added new mandatory reporting requirements for certain insurers and self-insured entities to notify the Centers for Medicare and Medicaid Services (CMS) and Medicare beneficiaries who have received a settlement, judgment, award or other payment. Recently, CMS issued guidance that clarifies some of the reporting requirements for certain Qualified Settlement Funds (QSFs), Total Payment Obligation to Claimant (TPOC) amounts and Liability Medicare Set-Aside Arrangement (LMSA) amounts.

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