June 22, 2012
New MMSEA TPOC Reporting Thresholds Posted, Further Alerts Anticipated
In a recent Alert, the Centers for Medicare and Medicaid Services posted new mandatory minimum Total Payment Obligation to Claimant reporting thresholds as applicable through January 2015. What sets this June 20, 2012 Alert apart from previous directives is that the minimum TPOC reporting thresholds previously decreased to no threshold – such that all liability insurance (and self-insurance) personal injury settlements, judgments, awards and other payments to a Medicare beneficiary would require reporting in 2015. The June 20 Alert gradually decreases the minimum TPOC amount to $300. Thus for cases with a TPOC date on or after 10/1/2014, if the TPOC is over $300, the settlement will need to be reported in the first quarter of 2015. The current TPOC minimum threshold requires reporting where the settlement, judgment, award or other payment exceeds $50,000. This amount decreases over the upcoming months as set forth in the Alert.
With this Alert, the $300 threshold previously implemented for certain liability insurance (and self insurance) recovery cases, that had excluded exposure, ingestion and inhalation cases, will now apply to all liability insurance and self insurance recovery cases. Click here to read the Alert.
Similar Alerts were issued regarding Workers’ Compensation and are available here.
In June 19′s NGHP Town Hall Teleconference, the CMS stated that Alerts were forthcoming and a new MMSEA Section 111 Medicare Secondary Payer Mandatory Reporting User Guide ought to issue before the 4th of July holiday.