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Text of CMS ANPRM on Civil Money Penalties Under the Medicare, Medicaid, and SCHIP Extension Act of 2007
Centers for Medicare & Medicaid Services, U.S.Department of Health and Human Services [Official Guidance] Dec. 11, 2013
"This advance notice of proposed rulemaking (ANPRM) solicits public comment on specific practices for which civil money penalties (CMPs) may or may not be imposed for failure to comply with Medicare Secondary Payer reporting requirements for certain group health and non-group health plans arrangements.... We are interested in comments and proposals to specifically define 'noncompliance' in the context of the phrase, 'for each day of noncompliance with respect to each claimant' in sections 1862(b)(7) or (b)(8) of the Act. We are seeking public comment and proposals on mechanisms and criteria that we would employ to evaluate whether and when the agency would impose CMPs. In addition, we are we are soliciting comments and proposals for methods to determine the dollar amount of a CMP that would be levied for each day that NGHP is a responsible reporting entity noncompliance under section 1862(b)(8) of the Act. We are also soliciting comments on how we might devise a method(s) and criteria to determine which actions would constitute 'good faith effort(s)' taken by an entity to identify a Medicare beneficiary for the purposes of reporting under section 1862(b)(8) of the Act. We are specifically soliciting comments and proposals from insurers, third party administrators for GHPs, other applicable plans, and the public."
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