Medicare Voluntary Data Sharing Agreement

The employer`s voluntary agreement on data sharing is another way to meet the requirement of data over-compliance. As part of this Agreement, an employer shall communicate with CMS information relating to the coverage of the group health plan. In return, CMS agrees to provide the employer with Medicare authorization information for identified Medicare individuals. The Centers for Medicare & Medicaid Services (“CMS”) has suspended the IRS-SSA-CMS data reporting requirement for employers. The data monitoring program was designed to help CMS identify Medicare-eligible individuals who also had access to employer-funded benefits. The CMS website for data comparison reports has been shut down and CMS will no longer send letters to employers requesting data on employees and participants. Under the program, employers were required to provide health insurance information for their authorized workers and spouses to Medicare. CMS would send a questionnaire to employers asking the employer to indicate certain participation data. To meet the data request, the employer had to create an account with CMS. After the account was activated, the employer was required to provide information about its health plan and answer questions about the staff and participants involved. Congress passed legislation (Section 6202 of the Omnibus Budget Reconciliation Act of 1989) to provide CMS with better information about the Group Health Plan (GHP) coverage of Medicare recipients. The law required the Internal Revenue Service (IRS), the Social Security Administration (“SSA”) and the CMS to exchange information about whether Medicare recipients or their spouses were working.

The process of sharing this information has been called IRS-SSA-CMS Data Match. The purpose of the data card was to identify situations in which another payer, such as a GHP, would have had to pay all or part of a claim paid by Medicare. . . .