CMS Alert Regarding Reporting of No-Fault Insurance Limits


CMS issued an alert on June 8th to remind RREs to include both Med Pay and Personal Injury Protection (PIP) coverage amounts when reporting No-Fault Insurance Limits under Section 111. When Med Pay and PIP coverages exist under the same policy and are being paid for the same party and incident, both coverage limits need to be included in the No-Fault Insurance Limit in order for the amount reported to accurately reflect the policy limit. Once the Med Pay and PIP coverage limits are both exhausted, termination of Ongoing Responsibility for Medicals can be reported.


The full Alert can be found at: https://www.cms.gov/files/document/alert-reporting-no-fault-insurance-limit-non-group-health-plan-nghp-claim-input-files.pdf.


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