Questions About MRCE

Why is FARA's MMSEA Section 111 service offerings so much more economical than its competitors?

We are able to price the transactional cost of our electronic reporting to Medicare low because we are re-using existing technologies throughout much of the process. Our model strives to sell this solution completely over the Internet so that we do not have to pass on additional overhead costs for sales commissions, travel, trade shows, and magazine ads. We are anticipating that our market share will be the more tech savvy buyer who seeks out a solution like ours using Internet search engines and wants the flexibility to change vendors without a lot of headaches.

What steps do I have to take to get signed up to MRCE?

After you determine that our services are the right choice for your compliance needs, we are confident that we can implement our solution quickly. Simply fill out the form on the home page to sign up. Once you sign up, you will be contacted by a FARA Business Services rep that will aid you in your account creation and training.

If you have not already registered your company with CMS, you will need to do so to obtain an RRE and pin number. Additionally, you will then need to perform your Account Setup with CMS. (For additional information, see question "How do I setup my account with CMS?" below.)

Typically, how long does it take once I sign the contract to get fully functioning reporting?

Assuming that Medicare is ready to accept claim input records after April 1, 2010, we expect the entire first quarter of 2010 will be filled with claimant query testing, training our clients on how to use the system, and educating our clients while sharing best practices with them. You can expect that we will have your account functioning as promised within 30 days.

What makes MRCE a better solution, and what makes FARA Business Services a more reliable source?

First, we elected to build a solution to address the needs of our existing client base, so we looked at the investment as something we had to do anyway. We have and continue to spend additional money and effort to extend this system to other organizations as a stand alone web app available and delivered in the SaaS model.

We believe the user interface is simple, clean, easy to learn and easy to use. We doubt our competition has emphasized the user experience in their design as well as we have. The service that is provided by MRCE is relatively basic, it involves capturing data to securely send one or two types of records to Medicare. So, it might be a stretch for us to claim that we do it so much better than competitors. What we provide is a simple service at a reasonable cost along with expertise and great support.

We do not have commissioned sales people and high overhead to factor into our cost model. We are a services company and are experts at providing similar services. FARA has been providing insurance related technology solutions for over 15 years. We already had the infrastructure in place to support this type of offering.

Questions About FARA

Does FARA offer any other solutions?

Yes. FARA offers a suite of web-based solutions that range from premium auditing, to claims management information systems, to risk intelligence management. To learn more about FARA's other technology and professional services offerings, please click here.

Questions About the Law

How do I setup my account with CMS?

You must register with CMS and obtain an RRE ID and Pin Number and perform your Account Setup. With respect to the Account Setup, you will need to identify a Reporting Agent (typically your company) and an Account Manager (typically the employee within your company who is responsible for reporting to CMS). While FARA will not be your Reporting Agent or Account Manager, a FARA employee can be identified as an Account Designee.

What is the intent of the new Medicare Reporting law?

Medicare is a secondary payer to certain types of non-group health insurance coverage, such as liability insurance (including self-insurance), no-fault insurance, and worker's compensation, and wants to insure that it does not pay primary instead of secondary when a claim is made against a policy of liability insurance (including self-insurance), no-fault insurance, or worker's compensation.

What must be reported and why?

All claims for liability insurance (including self-insurance, no-fault insurance, and workers' compensation that involve a Medicare Beneficiary and (i) that are addressed or resolved (or partially addressed or resolved) through a settlement, judgment, award or other payment on or after January 1, 2010 or (ii) involve ORM (Ongoing Responsibility for Medicals) on or after July 1st, 2009.

MMSEA is intended to provide information to the Centers for Medicare and Medicaid Services ("CMS") regarding payments being made to Medicare Beneficiaries from payment sources that are primary to Medicare in order that the Medicare Secondary Payer Recovery Contractor ("MSPRC") can potentially recover funds paid or payable to a Medicare Beneficiary for a Medicare covered benefit.

What are the two types of electronic reports to CMS/COBC?

(i) Total Payment Obligation to Claimant (TPOC)
For a TPOC, the settlement, judgment, award or other payment must be reported (report only once regardless of whether it is funded through a single payment, an annuity or a structured settlement).

Report the earlier of (i) obligation for payment is entered into; or (ii) actual payment is made. For example, if a settlement is entered into but requires court approval, do not report until obtain court approval, unless payment is made prior to court approval in which case the payment would need to be reported. Or, if a judgment/award is issued but is under appeal/negotiation, it is not reportable unless payment is being made pending the appeal/negotiation.

(ii) Ongoing Responsibility for Medicals (ORM)
ORM will generally require two reports. The first report is needed when the ORM is assumed and the second when the ORM is terminated. The only exception to the 2 reports is when the assumption and termination are reported on the same record or if a previously submitted record needs to be updated/deleted/corrected.

Exceptions

• For liability and no-fault, the Date of Incident is prior to December 5, 1980.
• No claim for medicals and the settlement, judgment, award or payment does not have the effect of releasing liability for medicals.
• For ORM assumed prior to July 1, 2009, if the claim was actively closed or removed from current claims records prior to January 1, 2009, the RRE is not required to identify and report the ORM. If such claim is later reopened for further ORM, it must be reported with full information, including the original date of incident (DOI).
• Claims that fall below certain DeMinimis Thresholds