Medicare, Medicaid and SCHIP Extension Act's New Requirements


The Medicare, Medicaid and SCHIP Extension Act of 2007, or MMSEA, affects judgments and settlements involving Medicare liens. Plaintiffs and Defendant attorneys should be aware of the changes. Section 111 of the MMSEA adds reporting rules, requiring defendants and insurers to report judgments/settlements with Medicare beneficiaries to the Department of Health and Human Services.

Section 111 of MMSEA is directed at identifying claims where Medicare has a right of recovery. The mandatory reporting requirements allow the Centers for Medicare and Medicaid (CMS) to identify those claims. Section 111 applies to Group and non-Group Health Plans, workers' compensation, liability insurance, no-fault insurance, and self-insurers. All entities which pay settlements, judgments, awards or other payments to Medicare eligible beneficiaries beginning January 1, 2010 are required to report the claim to CMS.

For more info, you can visit the Centers for Medicare and Medicaid website.