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Section 111 Reporting System

A Premier Medicare Compliance Service Provider

Section 111 Reporting

In 2007, as a means of enforcing the Medicare Secondary Payer (MSP) recovery laws ,Congress passed the Medicare, Medicaid and SCHIP Extension Act (MMSEA). This Act, also known as Section 111 Reporting, specifies that settlements, judgments, awards or other payment(s) made to a Medicare beneficiary as a result of a personal injury claim, must be reported to Medicare. Penalty for failure to do so can be up to $1,000/day per claim.


Section 111 Querying & Reporting System

Flagship brought together multiple professional resources in a collaborative effort to develop the best-in-class Section 111 Reporting solution, the LumenX®, that handles every aspect of Medicare Querying and Reporting for Responsible Reporting Entities (RREs). Flagship’s LumenX system eliminates technical complexity from the reporting process, provides secure data transmission and keeps an historical record of all submissions to, and responses from, Medicare, for an easy-to-access Section 111 Reporting audit trail. LumenX® is the most accurate, efficient, and scalable Querying and Reporting system in the industry.

LumenX – Section 111 Querying

Achieving 100% compliance with Medicare regulations begins with a monthly query of the Medicare database to identify Medicare beneficiaries. “Getting querying right” means (1) identifying all claims involving personal injury,then (2) ensuring all the data required to query Medicare’s database has been sourced for each claim.

LumenX – Easy, Accurate, Secure

Easy – LumenX is a web-based solution that requires no in-house hosting. It has user-friendly interface that makes it simple to find individual and aggregated information about Medicare reporting.

Accurate – All software updates are managed by Flagship and occur seamlessly, with no technological impact.We track Medicare’s constantly evolving regulations and procedures so you don’t have to. LumenX validates all data for errors before submitting your quarterly report. Incomplete data is flagged so the missing data can be inputted. The result is an industry-leading Medicare acceptance rate of 99.96%.

Secure – LumenX servers are fully redundant, and hosted in a state-of-the-art environment.

  • Progressive Insurance Company Settles Medicare and Medicaid Secondary Payer False Claims Act for $2.4 Million (11/22/2018)- Auto, liability, no-fault, and work comp primary payers- if you didn’t take Medicare and Medicaid secondary payer issues seriously before, here are over 2 million reasons why you should. On November 14, 2017, the United States of America, the State of New Jersey, Progressive Garden State Insurance Company, Progressive Casualty Insurance Company, and Relator Elizabeth […]
  • Judge Writing Medicare 2019 Thresholds (11/20/2018)- The SMART Act requires the Centers for Medicare & Medicaid Services (CMS) to review its costs related to recovering conditional payments compared to recovery amounts annually. After their analysis, CMS announced the reporting thresholds for Liability, No-Fault and Workers Compensation claims for 2019. CMS calculated a threshold for physical trauma-based liability insurance settlements. “Effective January […]