CMS Final Rule and Section 111 Noncompliance: Reporting Obligations; Audit Methodology; Costly CMPs; Safe Harbor
Recording of a 90-minute CLE video webinar with Q&A
This CLE webinar will guide practitioners through CMS' recently released final rule implementing civil money penalties (CMPs) for failure to comply with MMSEA Section 111 reporting. The CMP Rule, "Medicare Secondary Payer and Certain Civil Money Penalties," has an effective date of Dec. 11, 2023 and an applicability date on or after Oct. 11, 2024. The CMPs levied may exceed $365,000, as adjusted annually for inflation, for each incident of non-reporting.
- Section 111 overview and background
- Section 111 of MMSEA
- The SMART Act
- Final rule including modifications from the proposed rule
- Covered entities/RREs
- Audit methodology
- Reporting exceptions and safe harbor provisions
- Governing time periods including statute of limitations
- Notice and appeals process
- Best practices for compliance
The panel will review these and other important considerations:
- How does the final rule differ from the proposed rule?
- Who are RREs?
- Under what circumstances are CMPs imposed and how are they calculated?
- What are the safe harbor provisions described in the final rule?
- What is the appeal process when CMPs are imposed?
- What does this mean for plaintiff attorneys?
Catherine E. Goldhaber
Hawkins Parnell & Young
Ms. Goldhaber defends claims related to product liability, exposure to toxic substances and transportation-related... | Read More
Ms. Goldhaber defends claims related to product liability, exposure to toxic substances and transportation-related injuries. She handles matters directly in Illinois and Michigan and manages multi-state litigation as national coordinating and trial counsel. Ms. Goldhaber counsels clients in Medicare Secondary Payer (MSP) issues, particularly as the issues arise throughout discovery and in resolution.Close
Barrye Panepinto Miyagi, JD, CMSP-F
Partner, Practice Leader Medicare Secondary Payer Compliance Group
Taylor, Porter, Brooks & Phillips
Ms. Miyagi advises clients in liability, workers’ compensation, and no-fault matters on MSP compliance-related... | Read More
Ms. Miyagi advises clients in liability, workers’ compensation, and no-fault matters on MSP compliance-related settlement and trial strategy. She also assists defendants and insurers in evaluating all aspects of mandatory reporting under the Medicare, Medicaid, and SCHIP Extension Act (MMSEA) of 2007. Ms. Miyagi has authored MSP compliance best practices for Fortune 500 companies, served as lead MSP compliance counsel in large, multiparty cases, and represented clients on MSP compliance issues in federal and state courts. She and her team resolve MSP issues in single plaintiff and multi-party cases. Ms. Miyagi also handles MSP global lien resolutions on behalf of her clients who seek an efficient means of resolving Medicare and Medicare Advantage Plan interests in mass tort settlements. She has over 30 years of litigation experience defending mass tort and other personal injury cases. Ms. Miyagi has handled large-scale litigation and settlement dockets. She works with plaintiff and defense firms across the nation to establish MSP-compliant settlements. As a result of her experience, Ms. Miyagi brings a unique perspective to MSP compliance issues and is an asset to her clients who seek guidance on all aspects of claim resolution. She is a frequent speaker on MSP Compliance and has presented to the Defense Research Institute, the National MSP Network, RISE, and the Federal Bar Association to name a few.Close