Subsequently, the Medicare Access and CHIP Reauthorization Act (“MACRA”) amended some of the provisions of Medicare Secondary Payer of the Social Security Act to no longer require this information. As a result, the IRS-SSA-CMS Data Match program has been discontinued. Under the program, employers were required to provide CMS with information about the health care of their Medicare-eligible workers and spouses. CMS would send a questionnaire to employers that would require the employer to provide certain data on participants. To meet the demand for data, the employer had to create an account at CMS. After the account was activated, the employer was required to provide information about its health plan and answer questions about the staff and participants involved. This statement by insurers and TPAs has no direct impact on employers. However, employers should be aware of these reports for two reasons. First, CMS will know if an employee has PGP coverage. Therefore, if employers and workers have a medicare claim, Medicare`s employer may hear that they are seeking a refund. Although the IRS-SSA-CMS Data Match has been terminated, cms encourages employers to consider entering into a Voluntary Data Sharing Agreement (VDSA) with CMS to exchange 2012 and Medicare Internet Access Data.
Some large employers have already entered into VDS with CMS to exchange coverage information. For more information about the VDSA program, click here on the Voluntary Data Sharing Agreement page. The Centers for Medicare – Medicaid Services (“CMS”) has suspended the requirement for employers to report IRS-SSA-CMS data. The data matching program was developed to help THE CMS identify Medicare-authorized individuals who also had access to employer-sponsored services. The CMS data notification site has been closed and CMS no longer sends letters to employers requesting data from staff and participants. Timing is extremely important for these packages of needs. It is imperative that they do not sit on the desk without action. CMS COB-R has good information on its website. Make sure you have a primary and secondary person who understands the process and can respond within the time frame described in the letters you receive from CMS COB-R. Unless an MSP case is resolved by a full payment or a valid defence within 60 days, the interest on the debt begins to be settled on the 61st day.
Partial payment or partial defense does not stop the timeline. On the 61st day, an ItR (Intent to Refer) letter was written indicating that the COB-R CMS intends to return the debts to the U.S. Treasury for collection. You can still mount a defense on the ITR letter, but if the full payment or valid defense is not received before day 240, the debt will be returned to the U.S. Treasury. Federal law allows the U.S. Treasury to recover unresolved debts, and if you receive federal funds for a program, you can intercept those funds to deal with MSP debt. This has happened in recent years to a number of agencies. It is essential that these cases be resolved quickly, because once these cases are before the U.S. Treasury, you will only have 10 days to challenge the debt before the Treasury can begin to recover the debt. Once the funds are taken by your agency, the task of recovering these funds is long, tedious and almost impossible. If you have any questions, please contact your HUB advisor.
Other compliance items can be included in our compliance directory. It is not possible to realize the importance of solving them, if possible within the first 60 days. This may mean that you must train anyone who receives mail in your agency to recognize any of these letters sent by the COB-R CMS or the U.S. Treasury Department, to manage them with the highest priority and bring them to the right person in your agency to contact Norm Rice at the HCA. Another indication is that letters from the U.S. Treasury Department or letters from one of their private collection offices assign a separate identification number and assign the name of the person in the collection information.