CMS Solicits Comments on Imposing Penalties for Noncompliance with Section 111 Reporting Requirements

CMS recently issued an Advanced Notice of Proposed Rule Making (ANPRM) in which it solicits comments for practices in which civil monetary penalties may or may not be imposed for failure to comply with Section 111 reporting requirements. Specifically, CMS is requesting comments and proposals:

• to define “noncompliance” in the context of the phrase “. . . for each day of noncompliance with respect to each claimant . . . “ in sections 1862(b)(7) or (b)(8) of the Act- 42 U.S.C. 1395y(b)(7)(B) and (8)(E); 
• on mechanisms and criteria to evaluate whether and when CMS would impose civil monetary penalties; 
• for methods to determine the dollar amount of the civil monetary penalty that would be levied each day of noncompliance; and 
• to devise a method(s) and criteria to determine which actions would constitute “good faith effort(s)” to identify a Medicare beneficiary for Section 111 reporting purposes. 

All interested parties, including insurers, third party administrators for Group Health Plans, and any other applicable plan, should submit comments as doing so will shape the application of monetary penalties for failure to comply with Section 111. Comments must be provided no later than February 10, 2014.