The Department of Health and Human Services Centers for Medicare & Medicaid (CMS) changed the initial production date for submitting non-group health plan (NGHP) input files from April 1, 2010 to January 1, 2011. All NGHP RREs should now be registered with CMS’ Coordination of Benefits Contractor (COBC), and either in, or preparing for, file testing status. NGHP file data exchange testing will continue through December 31, 2010. CMS encourages NGHP RREs that have completed file data exchange testing to proceed to production file data exchange status. Sometime this week, CMS will post a new version of the “Section 111 NGHP User Guide” along with an alert describing the steps NGHP RREs can take to assure their ongoing compliance with the Section 111 reporting requirements.

The real impact of this change is that the penalties for not reporting will not go into effect until January 1, 2011. However, Medicare is not waiving its rights to recover the conditional medical payments it makes on behalf of Medicare beneficiaries. NGHP RREs are still responsible for reimbursing Medicare for its conditional payments. Additionally, NGHP RREs will still be potentially liable for double damages if the government brings an action to recover reimbursement of its conditional payments.