Medicare’s New Mandatory Reporting Requirements for Primary Payers

Effective July 1, 2009, the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) signed by President Bush on 12/29/08 requires that all liability carriers (including self-insurers), no-fault insurers and Workers’ Compensation insurers report detailed information to Medicare. No fault and non-contested Workers’ Compensation claims need to report on a quarterly basis. Contested cases and liability cases with single judgment, award or other payment need to report at the time of settlement. The penalty for failing to report the required data carries a fine of $1,000 per claim per day. The failure to confirm Medicare was reimbursed could lead to a recovery action that could result in the insurer paying twice the amount of Medicare’s conditional payment. For further information or questions, please contact Paul Rajkowski.