Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: January 30, 2019

Program Area: CSR Reconciliation (CSR)

Question: Under what circumstances would an issuer not be allowed to re-submit Benefit Year 2014 CSR data in 2017 CSR filing?

Answer: CMS expects issuers to reconcile all claims in a timely manner. Please see page 6 of the Manual for Reconciliation of the CSR Component of Advance Payments for Benefit Years 2014 and 2015. To the extent that issuers have late claims for 2014, for example due to appeals or unusual circumstances (to be determined by CMS), issuers may re-adjudicate and submit claims from the 2014 benefit year in the next CSR reconciliation reporting cycle in April of 2017.

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