Section 111 Medicare Secondary Payer (MSP) Records Will Accept Future Effective Date

Effective October 4, 2021, Section 111 MSP record submissions will accept effective dates up to three months in the future for certain Non-Group Health Plan (NGHP) claims.  Because Medicare entitlement records may have effective dates up to three months in the future, CMS is updating the COB&R systems to accept these future MSP effective dates.  When a S111 Ongoing Responsibility for Medical (ORM) NGHP record is submitted, and the Medicare Beneficiary’s entitlement is in the future (up to 3 months), the system will now create an MSP record with a future MSP Effective Date. For example, if a Responsible Reporting Entity submits a claim that it has an ORM for on 10/05/2021 and the beneficiary’s Medicare entitlement date is 01/01/2022, the Benefits Coordination and Recovery Center (BCRC) will now accept the Medicare entitlement date of 01/01/2022 as the MSP effective date.

Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.