John Tobey, VP Home Office Claims & Quality Assurance FOR IMMEDIATE RELEASE
Phone: (609) 495-0059 April 2, 2009
Email: John.Tobey@REMLtd.com
REM CUSTOMER ALERT
Gould & Lamb Selected for MMSEA/SCHIP Compliance
On July 1, 2009, new Mandatory Insurer Reporting (MIR) requirements for eligible workers’ compensation, liability and no-fault claims will go into effect, per Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA). After diligent review of the nation’s best MIR service providers, REM has selected Gould & Lamb, LLC as our preferred partner to ensure compliance with this new legislation.
Under Section 111, any time a claim is filed, the Responsible Reporting Entity (RRE) must determine whether the claimant/plaintiff is eligible for Medicare. When the RRE encounters a claimant/plaintiff who is so entitled, they must “report the identity of such claimant/plaintiff and provide such other information as the Secretary may require.” Reporting will be on a quarterly basis, except for “contested” cases, which are reported at the time of settlement, judgment, or award only. Failure to report carries a $1,000.00 per day, per claim penalty.
REM has designated Gould & Lamb as its preferred vendor for our customers’ claim settlements that are determined to require a Medicare Set Aside, Claim Settlement Allocation and other services related to Medicare Secondary Payer (MSP) compliance. We believe Gould & Lamb is the best-qualified provider to deliver the elite level of service that REM and our customers expect.
The first critical step required of our customers is registration with Centers for Medicaid and Medicare Services (CMS) as an RRE. Simply put, the RRE is the party that is the funding source for payments made to the Medicare beneficiary. This mandatory registration process must occur between May 1 and June 30, 2009. It is critical that you register as soon as possible. CMS is due to release instructions about entities that qualify as an RRE shortly. We will be supplying these instructions to our customers to aid in determining if you are an RRE as soon as they are published. The CMS communication is expected to contain information such as how many RRE ID’s are needed and detailed registration instructions to assist in making this a smooth and successful process. It is important to remember that the TPA is never the RRE.
Gould & Lamb will be hosting webinars for our customers over the coming weeks to assist them in taking the appropriate actions and to ensure that we have all of the required information following the registration process to begin testing of our Mandatory Insurer Reporting (MIR) solution on July 1, 2009.
Gould & Lamb has committed both Information Systems (IT) resources and Operational Workflow resources to the implementation project to ensure the delivery of a complete and successful solution in accordance with CMS deadlines. Our staff will be undergoing the appropriate training to ensure that field activities comply with the new regulations.
REM will be providing further details in subsequent communications. We will also be posting updates on our website in order to assure that you have access to the latest information that we receive from CMS and Gould & Lamb.
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Contact: John Tobey, VP Home Office Claims & Quality Assurance
Phone: (609) 495-0059
Email: John.Tobey@REMLtd.com
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