Tag: Section 111 Reporting Penalties

CMS Sets October 17 for Webinar on Section 111 Reporting Penalties

October 9, 2024

CMS Webinar on Section 111 Reporting Penalties

Upcoming CMS Webinar on Section 111 Reporting Penalties

The Centers for Medicare and Medicaid Services (CMS) has scheduled an important webinar on October 17, 2024, at 1:00 PM ET, specifically covering Section 111 reporting Civil Money Penalties (CMPs) and their implications for all relevant stakeholders involved in compliance and reporting.

Webinar Format and Focus From CMS

CMS will be hosting a comprehensive webinar regarding Certain Civil Money Penalties for NGHP Responsible Reporting Entities (RREs). This informative session aims to clarify the implications of these penalties and ensure that all RREs are well-informed. The format will include opening remarks from CMS officials, followed by a detailed presentation that will cover essential topics. Attendees can expect reminders about the Final Rule, insights into the auditing process, and critical dates that RREs need to remember. After the presentation, there will be a dedicated question-and-answer session, allowing participants to seek clarification and address specific concerns related to the Civil Money Penalties. This interactive component is designed to enhance understanding and foster engagement among all attendees.

RREs who would like to submit questions in advance of the webinar are encouraged to do so using the dedicated resource mailbox at Sec111CMP@cms.hhs.gov.

There is no pre-registration for the webinar.  Full details can be found here.

Previous Webinar Insights

The upcoming webinar focuses on Section 111 penalties, while a previous webinar covered Section 111 reporting best practices and upcoming changes. A copy of the slides and notes of the prior session are here.

CMS recently added a new page to its website, which provides NGHP Civil Money Penalties information, including a flow chart.  CMPs are applicable starting October 11, 2024, and audits begin in January 2026. We encourage a review of CMS’ website and articles Tower has published on the topic, including Section 111 Reporting for WCMSAs & Avoiding Civil Penalties.

Premier Webinar: Get Ready for Section 111 Reporting Penalties and WCMSA Reporting

May 3, 2024

Premier Webinar: Section 111 Reporting Penalties & WCMSA Reporting

CMS Announces Section 111 Mandatory Insurer Reporting Changes: Penalties and New WCMSA Requirements

The Centers for Medicare and Medicaid Services (CMS) has released several announcements regarding Section 111 Mandatory Insurer Reporting over recent months.  Some relate to Section 111 penalties and some to the new requirement to add Workers’ Compensation MSAs to Section 111 reporting.

Timely and accurate Section 111 reporting is essential if you want to avoid penalties. And WCMSA reporting will introduce new tasks for claims professionals and potentially affect how WC cases with Medicare beneficiary claimants are settled.

To help you and your organization prepare for these changes

Tower will hold a “Get Ready for Section 111 Reporting Penalties and WCMSA Reporting” webinar on May 22.

Please join Tower’s Chief Compliance Officer Dan Anders and Chief Technology Officer Jesse Shade for this valuable, instructional session. Scheduled for Wednesday, May 22, 2024, at 2 pm ET, the hour-long webinar will address:

  • Criteria and timeline for the implementation of Section 111 Reporting penalties.
  • Practices to mitigate and eliminate the potential for penalties.
  • How a Section 111 reporting audit can identify errors, blind spots and recommend corrective actions to your systems and processes.
  • Criteria and timeline for Workers Compensation MSA reporting.
  • Implication of WCMSA reporting for claims professionals, attorneys, and settling parties.

A Q&A session will follow the presentation, and you can provide questions ahead of time at registration. Please click the link below and register today!

Register Here

CMS Extends Deadline for Publication of Final Section 111 Penalties Rule

February 20, 2023

Stamp icons representing regulatory enforcement of Section 111 reporting by CMS.

There was much expectation that the Centers for Medicare and Medicaid Services (CMS) would meet the February 18, 2023 deadline to release a final rule on Section 111 reporting civil money penalties (CMPs). However, it was not to be.  CMS extended its deadline for publishing the final rule by a year to February 18, 2024.

Recall that the purpose of the rule is to set out specific criteria for when CMS may impose penalties for what it considers a failure to report or improper reporting.  A summary of the proposed rule can be found here.

In the notice, CMS explains the reason for the extension:

. . . We are not able to meet the initial targeted 3-year timeline for publication due to delays related to the need for additional, time-consuming data analysis resulting from public inquiry. It was not possible to conclude this data analysis on the initial, targeted timeline for the proposed rule because public listening sessions raised additional concerns that CMS believed were important to properly and thoroughly research prior to publishing the final rule. We have decided that it is critical to conduct additional analysis about the economic impact of the rule. We are preparing additional data analysis and predictive modeling to better understand the economic impact of the proposed rule across different insurer types. This data analysis is designed to review the actual current reporting and model potential penalties that would be imposed were the final rule in place. Along with delays resulting from the agency’s focus on the COVID- 19 public health emergency, we determined that additional time is needed to address the complex policy and operational issues that were raised. We are extending the publication deadline so as to provide the most accurate, complete, and robust data possible to confirm the intent and economic impact of the final rule.

Practical Implications

Besides not having to worry about penalties for another year, we are pleased CMS is taking the time to complete a data analysis of the impact of its penalty regulation.  While in its initial regulatory announcement, CMS indicated its rule would not have a significant economic impact, we, as well as others, noted in our comments to the proposed regulation that the authority to impose penalties of up to $1,000 per day per claim could lead to millions of dollars of penalties on even one claim.  This is most definitely a significant economic impact.

As required by law, CMS will eventually make its penalties rule final and issue penalties.  Accordingly, while we await that final rule, you have been granted more time to ensure the accuracy and timeliness of your reporting.

Current Tower Section 111 reporting partners have access to our Section 111 Management Dashboard, which gives you complete visibility into your claims from a global level all the way down to specific claims.  This, along with our standard error reports and consultation on error correction, is the best path forward to eliminate the potential for CMS to impose penalties.

If you do not yet partner with Tower for Section 111 reporting, now is an excellent time to consider the benefits of a platform which seamlessly manages Section 111 reporting, conditional payments, Medicare Set-Aside triage, clinical and legal interventions, MSA preparation, and CMS submission activities.  Don’t hesitate to contact Tower’s Chief Compliance Officer, Dan Anders, at 888.331.4941 or daniel.anders@towermsa.com, with any questions.

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