CMS Adopts Reporting Penalty Rule with Maximum Fine of $365,000 per Claim

The Centers for Medicare and Medicaid Services recently adopted new rules authorizing penalties of up to $1,000 per day, per claim, capped at $365,000 per year, for failure comply with mandatory reporting requirements. CMS published the final rule on the Medicare Secondary Payer mandatory insurer reporting penalties Oct. 11. The rule limits CMS to imposing penalties to untimely “Total Payment Obligation to the Claimant” and “Ongoing Responsibility for Medicals” reporting. The trigger for reporting total payment obligations is a settlement, judgment, award or other...