What is the purpose of section 111 reporting?

What is the purpose of section 111 reporting?

The purpose of Section 111 reporting is to enable Medicare to correctly pay for the health insurance benefits of Medicare beneficiaries by determining primary versus secondary payer responsibility. Section 111 authorizes CMS and GHP RREs to electronically exchange health insurance benefit entitlement information.

What is an RRE number?

Responsible Reporting Entity (RRE) — the party that is responsible for funding a claim payment to an individual eligible for Medicare benefits is considered the Responsible Reporting Entity (RRE) under the provisions of the Medicare, Medicaid, and SCHIP Extension Act (MMSEA) of 2007.

What does NGHP mean?


Acronym Definition
NGHP Next Generation Home Products

What is Schip Medicare?

The State Children’s Health Insurance Program (SCHIP) is designed to provide insurance coverage for children whose families earn too much to qualify for Medicaid, but who cannot afford private coverage.

Who may be covered under a GHP?

First, the beneficiary must be age 65 or older and on Medicare because of age. Second, the insured person under the GHP must be either the beneficiary or the spouse of the beneficiary. Third, the GHP coverage must be based upon the current employment status of the insured person.

What is the Mmsea?

Definition. Medicare, Medicaid, and SCHIP Extension Act (MMSEA) of 2007 — a law that extended and expanded provisions of the Social Security Act relating to Medicare, Medicaid, and the State Children’s Health Insurance Program (SCHIP). Of particular note, Section 111 of the Act addresses Medicare secondary payer issues …

Why is Schip important?

Why is SCHIP so important? What is SCHIP? The State Children’s Health Insurance Program (SCHIP)1 is a partnership between the federal government and the states and is designed to provide health insurance coverage for targeted low-income children under age 19 who are not eligible for Medicaid.

Can you get Medicare early if you are disabled?

But, because Social Security only allows a maximum of 12 months of retroactive benefits, plus the 5-month waiting period for benefits, the earliest that you can become eligible for Medicare is one year after you apply for Social Security disability.

Can an employer force an employees to enroll in Medicare?

FAQs. Can an employer force an employee to enroll in Medicare? An employer can never force you to drop your group coverage and enroll in Medicare once you turn 65. You can always choose to have Medicare and decline your group plan, but your employer can never force that decision.

What is the section 111 registration Part I module?

Welcome to the Section 111 Registration Part I course. Note: This module applies to Responsible Reporting Entities (RREs) that will be submitting Section 111 claim information via an electronic file submission as well as those RREs that will be submitting this information via Direct Data Entry (DDE).

What is the section 111 cobsw registration process?

Registration and the Section 111 COBSW Section 111 RREs are required to register for Section 111 reporting and fully test the data exchange before submitting production files. The registration process provides notification to CMS of the RRE’s intent to report data to comply with the requirements of Section 111 of the MMSEA.

Where can I find information about Section 111 reporting requirements?

The NGHP User Guide is the primary source for Section 111 reporting requirements. RREs must also be sure to refer to important information published on the NGHP Alerts page. To obtain the most up to date information and requirements, refer to the NGHP User Guide and all pertinent alerts published subsequent to the current version of the User Guide.

Where can I find the section 111 statutory language?

The Section 111 statutory language, Paperwork Reduction Act Federal Register Notice and Supporting Statement can be found in the Downloads section below. An organization that must report under Section 111 is referred to as a responsible reporting entity (RRE).

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