Saturday, December 07, 2019
 

CMS Requires Prescription Drug Coverage Reporting under Section 111 MSP Reporting

Brought to you by:

http://www.ubabenefits.com

United Benefit Advisors

(317) 705-1800
support@ubabenefits.com

CMS Requires Prescription Drug Coverage Reporting under Section 111 MSP Reporting
By Karen Hsu, Director of Compliance at United Benefit Advisors

Oct 3, 2019 9:18:00 AM

The Centers for Medicare and Medicaid Services (CMS) revised its Section 111 Medicare Secondary Payer (MSP) User Guide and issued FAQs that require responsible reporting entities (RREs) to submit primary prescription drug coverage information as part of their Section 111 MSP Mandatory reporting requirements effective January 1, 2020.

The RRE for reporting primary prescription drug coverage is the entity that has direct responsibility for processing and paying prescription drug claims. In most cases, the RRE will be the insurer or TPA. For example, if the plan sponsor contracts with a third party such as a pharmacy benefits manager (PBM) to administer prescription drug coverage, then the PBM is considered the RRE for prescription drug reporting purposes. However, for self-funded plans that are self-administered, the RRE will usually be the plan administrator.

Copyright © 2001-2012 United Benefit Advisors, LLC. All Rights Reserved Terms Of Use Privacy Statement