MedicareIn an effort to reduce Medicare costs, Congress passed the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) on December 29, 2007. Because Medicare has been unable to identify primary payers consistently, Section 111 of the new Act (MMSEA) imposes mandatory reporting requirements for fully insured and self-funded group health plans.

These requirements impose an obligation on primary payers to identify claimants entitled to Medicare and to report those claims to Medicare electronically.

As of July 1, 2009. Health plans are required to report specific member eligibility data for members who meet certain age or disability criteria. The reporting rules apply to covered individuals age 45 and older for groups with 20 or more full or part-time active employees.

In order to comply with MMSEA, The Group Insurance Trust, Anthem Blue Cross and Seabury & Smith will work together to obtain the necessary data from members, employees and dependents. Insureds will receive letters and if necessary, follow-up phone calls to obtain the required information. Please be aware that this a mandatory Federal reporting requirement.

Failure to comply may subject Anthem Blue Cross, The Group Insurance Trust and potentially the covered group to a civil penalty of $1,000 per day for each day of noncompliance for each individual for which the information should have been submitted.

FAQ will be published Wednesday, please check back then for further information.