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Mailing re: Medicare Secondary Payer (MSP) Mandatory Insurer Reporting

Apr 24, 2012


Health Net Mailing to Employer Groups


To Our Valued Partners:

The Medicare Secondary Payer Mandatory Insurer Reporting (MSP-MIR) requirement of Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) includes a Group Health Plan (GHP) requirement that obliges health plans to report certain information to the Centers for Medicare & Medicaid Services (CMS). CMS is the federal agency that regulates the Medicare program.

The purpose of this reporting process is to enable CMS to more effectively pay for the health insurance benefits of Medicare beneficiaries who have coverage under group health plan arrangements.  In order to comply with this mandatory CMS requirements, Health Net is required to provide CMS with data back to January 1, 2009. The information Health Net must report includes employer Tax ID Number (TIN), worldwide employee count and SSN/HICN for subscribers and dependents age 45 years and older.

We periodically review our records on file and have determined that we must request additional information from some of our current and former group clients. We recently mailed the
attached letter to those clients from whom we must collect additional information.  Clients may return the completed forms to Health Net in the enclosed postage paid envelope or by fax; we are requesting that completed forms be returned by April 27, 2012 or as soon as reasonably possible.  If Health Net does not receive the required information, we may follow up with a phone call to our contact at the group.

If you have any questions, please contact you Health Net Account Representative.

* State laws that restrict the collection of SSNs do not apply in this case. Provisions of the federal Medicare as Secondary Payer (MSP) or Medicare Modernization Act (MMA) regulations or the “permitted use” provisions of the HIPAA privacy rules allow the collection and use of SSNs to help providers and insurers manage their operations. For more information about MSP reporting, please see the CMS website:
http://www.cms.hhs.gov/MandatoryInsRep/ .
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