Thursday, September 30, 2010

HHS posts update on claims submission process for Early Retiree Reinsurance Program

The Department of Health and Human Services (HHS) has posted an ERRP Update on their website regarding preparations for receiving plans’ retiree lists and claims data submissions for the Early Retiree Reinsurance Program (ERRP).

HHS states they will be ready to begin accepting retiree lists in early October, and plans are encouraged to begin preparing for the consolidation and submission of that information. HHS has not yet specified what information should be submitted in the retiree list, but it is likely to include the following member information:
• Social security number
• Name (first, last and middle initial)
• Gender
• Date of birth
• Relationship to early retiree
• Date of retirement (or of coverage under the early retirement plan)

The guidance further clarifies the ERRP reimbursement policy by describing the types of medical items and services which are generally excluded from Medicare coverage. These medical items and services will not credit the program’s cost threshold and will not be reimbursed.

The update also specifies that HHS will begin accepting summary-level claims data in mid-October. HHS also makes reference to submitting more detailed claims information at a later date. It is not yet clear what the format or frequency of either submission type will be.

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