Mandatory Insurer Reporting & MSP Consulting Services

The need for a trusted Medicare Secondary Payer (MSP) consulting partner is more apparent now than ever before. 

Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) requires the providers of liability insurance (including self-insurance), no fault insurance and workers’ compensation insurance to determine the Medicare-entitlement of all claimants and report certain information about those claims to the Secretary of Health and Human Services. The penalty for non-compliance remains at $1,000 per day, per claimant, for each day the insurer is out of compliance. Although Medicare has not imposed these penalties, they are coming. GRG will work with the reporting entities to ensure that their programs are compliant to avoid the potential for penalties. 

GRG has the knowledge, experience and resources to ensure total Medicare Secondary Payer (MSP) compliance for your programs. Two of those services are described below. 

MSP Consulting

GRG has extensive experience in helping companies implement procedures to ensure total Medicare Secondary Payer (MSP) compliance. Our comprehensive programs address all aspects of resolution and compliance, including MSP consulting, healthcare lien resolution, fund administration, and future medical allocations. GRG’s MSP Consulting services include:

  • Written guidelines for in-house MSP claim resolution “best practices”
  • Guidance on new Conditional Repayment Center requirements for resolution of payments
  • Written defense counsel MSP guidelines, including standing discovery orders and guidelines on MSP claim resolution
  • Standard MSP release language that protects the client from MSP contingent liabilities
  • On-site training to in-house claim and MSP experts
  • Periodic updates on significant development in the MSP
  • Letters and forms for obtaining the data required from claimants and/or their attorneys
  • Assistance in reviewing or developing processes and procedures to ensure reporting is being done in a compliant manner

Mandatory Insurer Reporting

GRG serves as the MMSEA Mandatory Insurer Reporting Agent for companies of all sizes. Our proprietary web-based reporting solution allows clients to securely report claims as required under the MMSEA to ensure compliance and avoid penalties. 

GRG assists firms in determining which claims to report and can also assist with ICD-9 and ICD-10 (medical) coding. Our cutting edge solution will save you countless hours of sorting through the requirements on your own. GRG’s Medicare Compliance Connection portal:

  • Ensures total compliance with Medicare’s reporting requirements
  • Features a user-friendly interface and an easy setup process
  • Integrates seamlessly with your existing claim management software
  • Gives clients a flexible system for uploading data to determine entitlement and to report settlements via Excel spreadsheet or B2B web service

Get started with GRG's Consulting and reporting services