Medicare Secondary Payer Status: The Impact of Section 111 Reporting Requirements

Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) requires property-casualty insurers and self-insureds to report to the Centers for Medicare and Medicare Services (CMS) certain information on medical treatments received by Medicare beneficiaries. The information concerns the medical treatments received by a Medicare beneficiary whose injury or illness is subject to a property-casualty insurance or self-insurance coverage. Medicare has long been the secondary payer for medical payments attributable to a property-casualty insurance or self-insurance coverage, and this has not changed under Section 111. It is the reporting requirements that have changed, and these changes may increase the losses for cases where Medicare has been making payments and has not been reimbursed by a primary payer (in this case, the property-casualty insurer or self-insured).

Keywords: Healthcare, Medicare, Worker's Comp, Automobile, Homeowners