David Y. Stevens, Associate, Spencer Fane Britt & Browne LLP
As of January 1, 2009, most group health plans became subject to the Mandatory Medicare Secondary Payer Reporting Program. On March 16, 2009, the Centers for Medicare and Medicaid Services (“CMS”) issued the latest version (“Version 2.2”) of the Group Health Plan User Guide for use by responsible reporting entities (“RREs”) under this Program.
The recent updates are generally clarifications, but they could be significant for certain RREs. While FSAs and HSAs are not reportable, HRAs are considered to be reportable group health plans. CMS has now clarified, however, that RREs need not report HRA coverage information until October 2010. The reason for this delay is to allow RREs time to gather the information needed to report on HRA coverage. CMS has indicated that it will provide further guidance on reporting HRA coverage at a later date.
The new User Guide also points out that CMS prefers RREs to use the Medicare “health insurance claim number” of a Medicare enrollee, if available, rather than the individual’s social security number.
RREs should download the latest User Guide from the CMS web page and review any other updates that may be applicable.
From United Benefit Advisors Benefits and Employment Briefing, Second Quarter 2009
Johnson & Dugan comment: Although MSP Reporting requirements are the responsibility of "an entity serving as an insurer or third party
administrator for a group health plan...", employers should be aware of the requirements and be prepared to respond to insurance carrier requests for information.
