SCHIP Act Reporting Requirements

SCHIP Act Reporting Requirements | The Medicare, Medicaid and SCHIP Extension Act requires only reporting of information. Each responsible reporting entity must comply with the SCHIP reporting requirement or suffer fines and penalties. In order to help employers comply, I would suggest the following four tips.

By JAMES POCIUS, an attorney and shareholder with Marshall Dennehey in Scranton, Pa., and an expert on Medicare and workers' compensation.

1. Medicare has established reporting registration starting on May 1, 2009. I strongly urge all responsible reporting entities to register during the time period between May 1, 2009, and July 1, 2009. Medicare has indicated that, if you register, even if the information flow is not yet perfected, the agency will not pursue penalties. They are strictly interested, at the present time, in establishing the procedures.

Oregon: Division seeks input on common funds claim balance (04/29/13)
Final rule expands construction standards to demolition workers (05/28/13)
Ohio: Bureau spells out rules for self-insuring employers (05/06/13)
Alaska: Board looks at medical billing and fees (05/13/13)
South Carolina: Commission adjusts fee schedule for surgery centers (05/13/13)

If you are self-insured, you may wish to talk to your third-party administrator about meeting the reporting requirements. While the self-insured will still be considered the responsible reporting entity, an agent can be designated to fulfill the reporting requirements. Medicare will recognize this agent.

2. Start now! Now is the time to contact all of the outstanding claimants or plaintiffs who you have on record. You must determine if they are Medicare eligible. If a person is 65 years old, they are eligible for Medicare. If a person is on Social Security Disability, they are also eligible for Medicare (after two years of payments). Once you are able to establish the identity of the Medicare eligible recipients, you will know what cases have to be reported.

With regard to workers' compensation, any person you are paying who is eligible for Medicare benefits must be reported.

With regard to liability matters, any cases that you are settling in which a person is qualified for a Medicare card are reportable. The time to find out who these people are is now!

3. Settle as many cases as possible before the reporting requirements begin with exchange of information on May 1, 2009. If your cases are resolved prior to May 1, 2009, you do not have to report them.

4. In order to get updates on the reporting requirements, including the actual IT requirements of reporting, please go to www.cms.hhsgov/mandatoryinsrep/. This CMS Web site is updated weekly as new developments occur.

At the time of the writing of this article, the agency has placed at least two proposed forms for responsible reporting entities on the Web site. These forms include all of the information necessary for reporting. The forms are still a work in progress.

April 1, 2009

Newsletter Sign-up