Wednesday, September 29, 2010

MMSEA Reporting Regarding Spouses

After your great presentation at the AAJ Nursing Home Seminar this weekend, I had an issue arise. A resident is deceased and suit was filed by both the estate and the wife. The case is settled. Medicare was involved via US attorney. Now, the defense is demanding that the wife's SSN to report to Medicare. The CMS memos I've found are silent on whether a spouse must give their SSN. This does not make sense to me that he/she would have to. Another dealt with this issue? I would prefer to protect my client's privacy. Thanks.

Wisconsin Attorney

You have asked a very good question and one that has not been asked very often; but yes, if the spouse is bringing a suit, then she will be required to provide her Social Security Number.

In the situation where the injured party is a Medicare beneficiary and is deceased; the reporting entity will need to report information under Section 111 about the injured party and also about the claimant. Page 169 of Version 3.1 of the User Guide provides the definition of a Claimant. "The claimant may be the beneficiary's estate, or other claimant in the case of wrongful death or survivor action." Claimant information will include who the claimant is, i.e. an estate or family member, the tax identification number of the claimant, the claimant's contact information and information about the claimant's representative, if applicable. If more than one claimant is bringing suit, then information will need to be provided for each claimant.

Fields 104-118 in Version 3.1 of the User Guide provide the instructions for reporting a suit brought by a claimant. Additionally, fields 119 -131 provide instructions for the information needed about the claimant's representative, i.e. representative's name or the firm name, tax identification number, and contact information.

Please let us know if you need any further information about this reporting requirement.

Our Best,
Matt Garretson, Esq.