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Mandatory Insurer Reporting For Non Group Health Plans What's New

Guidance for new information regarding Mandatory Insurer Reporting for Non-Group Health Plans (NGHPs) and NGHP Town Hall Events.

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

Issue Date: February 11, 2020

New information regarding Mandatory Insurer Reporting for Non-Group Health Plans (NGHPs) and NGHP Town Hall Events is posted here as it becomes available.

December 5, 2024 – Updated MMSEA Section 111 Non-Group Health Plan (NGHP) User Guide Now Available

The updated MMSEA Section 111 NGHP User Guide version 7.8 is available in the Download section of the NGHP User Guide page. Refer to Chapter 1 of each Chapter for a summary of updates.

November 25, 2024 – September 12th Section 111 Non-Group Health Plan (NGHP) Reporting Webinar Presentation Updated with Q&A is Now Available

The presentation from the September 12th Section 111 NGHP Reporting Webinar has been updated to include Q&A and is now available in the Download section below. 

October 29, 2024 – Testing Reminder for the Section 111 Change to Workers’ Compensation Reporting

This is a reminder that Responsible Reporting Entities (RREs) may now test the file layout changes for the upcoming change to S111 Workers’ Compensation Reporting.  These changes are scheduled to be effective April 4, 2025. RREs should test via the usual testing process. Please coordinate testing with your EDI representative.

Test beneficiary data may be downloaded from the Section 111 COB Secure Website for RREs to use in testing. These files can be found under the Reference Materials section after Login. Records submitted on a test file must have a TPOC date on or after October 7, 2024, to be subject to the new edits in the test environment.  Full details regarding the standard testing process is available in Section 9 of Chapter IV of the NGHP User Guide available in the Download section of the NGHP User Guide page.

October 24, 2024 – October 17th Medicare Secondary Payer and Certain Civil Money Penalties Non-Group Health Plan Webinar Presentation is Now Available

 The presentation from the October 17th Medicare Secondary Payer and Certain Civil Money Penalties Non-Group Health Plan webinar is now available in the Download section below.

October 7 , 2024 – Updated MMSEA Section 111 Non-Group Health Plan (NGHP) User Guide Now Available

The updated MMSEA Section 111 NGHP User Guide version 7.7 and the updated MMSEA 111 - 270/271 Health Care Eligibility Benefit Inquiry and Response Companion Guide for Mandatory Reporting NGHP Entities, Version 6.0 are now available in the Download section of the NGHP User Guide page. Refer to Chapter 1 of each Chapter for a summary of updates. 

September 24, 2024 – CMS to Host Medicare Secondary Payer and Certain Civil Money Penalties Informational Webinar 

CMS will be hosting a webinar regarding Certain Civil Money Penalties Final Rule for Non-Group Health Plan (NGHP) Responsible Reporting Entities (RREs). Full details including log in information is available in the announcement located in the Download section below. 

September 19, 2024 – September 12th Section 111 Non-Group Health Plan (NGHP) Reporting Webinar Presentation is Now Available

The presentation from the September 12th Section 111 NGHP Reporting Webinar is now available in the Download section below.

 

 

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.