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January 10, 2008

New Medicare Reporting Obligations

As part of the Medicare, Medicaid and SCHIP Extension Act of 2007 (S. 2499) signed into law by President Bush on December 29, 2007, a new Medicare secondary payor reporting rule is imposed, primarily on insurers and third party administrators (TPAs). 

In an effort to ensure proper responsibility for health claim payment, this law will require insurers, TPAs, and plan fiduciaries of self-funded, self-administered plans to collect data from plan participants and plan sponsors, regarding the availability of Medicare.  These entities will then have to report this information to the Secretary of Health and Human Services (HHS).  The law, which takes effect in 2009, imposes significant penalties, $1,000 per day, for non-compliance.  Between now and then, HHS will surely issue guidance on what, how, and when information must be collected and submitted to them. 

Again, the responsibility will rest with the insurer, TPA or other claims payor; though, these entities may be requesting information from the employer and plan participant(s).  We will keep you apprised as developments occur.

 

The information contained in this Benefit Beat is not intended to be legal, accounting, or other professional advice, nor are these comments directed to specific situations.

As required by U.S. Treasury rules, we inform you that, unless expressly stated otherwise, any U.S. federal tax advice contained in this Benefit Beat is not intended or written to be used, and cannot be used, by any person for the purpose of avoiding any penalties that may be imposed by the Internal Revenue Service.

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