• Matthew T. Dorius, Esq.

CMS Again Proposes to Solicit Public Comments on Section 111 Reporting Penalties

The most recent Regulatory Agenda for the Department of Health and Human Services includes another notice of a proposed rule on Civil Monetary Penalties and Medicare Secondary Payer reporting requirements. The text of the notice is set out below and is available at

Section 516 of the Medicare Access and CHIP Reauthorization Act of 2015 amended the Social Security Act (the Act) by repealing certain duplicative Medicare Secondary Payer reporting requirements. This rule would propose to remove obsolete Civil Money Penalty (CMP) regulations associated with this repeal. The rule would also propose to replace those obsolete regulations by soliciting public comment on proposed criteria and practices for which CMPs would and would not be imposed under the Act, as amended by section 203 of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act).

The notice references Section 516 of the Medicare Access and CHIP Reauthorization Act of 2015, which repealed reporting requirements related to the discontinued IRS-SSA-CMS Data Match Project. That project was discontinued, as it duplicated the information CMS received from group health plans through Section 111 reporting.

It is important to keep in mind that the notice does not state that CMS is actually issuing regulations yet on Section 111 reporting penalties. Rather, it indicates that CMS would solicit public comments on situations in which penalties would and would not be imposed. This does not mean that regulations are immediately forthcoming. Under Section 203 of the SMART Act, which was passed at the end of 2012, CMS was supposed to solicit public comments within 60 days. CMS solicited public comments at the end of 2013, but no regulations were issued. We will keep you updated regarding any changes concerning Section 111 penalties as well as opportunities to comment related thereto.

#Section111 #CMS #Reportingpenalties #Medicare #MedicareSecondaryPayerAct


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