Medicare Secondary Payer Statutes, Part II: Liability Settlement Issues


As discussed in a previous alert, self-insured health care providers face the same compliance requirements and challenges as do those primary payers that qualify as Required Reporting Entities (“RRE”) under Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (42 U.S.C. 1395y(b)(7) & (8)).

To date, the Center for Medicare and Medicaid Services (“CMS”) has put forth a formidable effort to establish reporting procedures for Liability Insurance, including Self-Insurance, No-Fault Insurance and Workers’ Compensation claims. Readers are encouraged to visit the CMS webpage for the most recent updates. (See This webpage contains all new alerts and announcements, as well as the dates for upcoming teleconferences and transcripts of previous teleconferences. As the reporting process matures and CMS continues to develop and refine both

policy and technical aspects of compliance, third party liability insurers continue to settle claims. The following is a sampling of some of the questions we have encountered in counseling clients in the claims settlement process.

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