New Medicare Reporting Act Requires Employer Cooperation
Texas Mutual Insurance Company is calling on employers to help it comply with the new Medicare, Medicaid & SCHIP Extension Act (MMSEA). The MMSEA is intended to ensure that the Medicare program does not pay for a beneficiary's care when another insurer has primary responsibility:- Please include your injured workers’ social security numbers and dates of birth on DWC Form-001, Employer’s First Report of Injury or Illness.
- To comply with these requirements, we may contact you if we do not have that information on each claim.
Under the MMSEA, carriers that provide liability, no-fault and workers’ compensation, as well as employers who pay their own claims, must identify the Medicare beneficiary status of claimants and report claim data to Centers for Medicare & Medicaid Services (CMS) on a quarterly basis.
Organizations subject to the MMSEA are called Responsible Reporting Entities (RREs). Texas Mutual is the RRE for claims reported to us by our policyholders.
RREs must register with CMS for reporting through September 30, 2009 and pre-test their electronic reporting before January 1, 2011. After that time, the MMSEA requires quarterly reporting.
Texas Mutual has partnered with a vendor to report claims to CMS. Through the vendor, Texas Mutual will use CMS’ Medicare eligibility tool to determine each claimant’s medicare beneficiary status. We will then report the Medicare-eligible claims to CMS on a quarterly basis, in the manner and format specified by CMS.
Services for Employers
Welcome to Texas Mutual Insurance Company, the state's leading provider of workers' compensation insurance. This site is a resource for employers who want to know more about us and the workers' comp system.
If you have questions, please feel free to contact us at information@texasmutual.com.
Why workers' comp?
Workers' compensation is the only coverage that provides medical and income benefits for injured workers and legal protection for employers. Employers who choose not to purchase workers' comp bear complete financial responsibility for an
employee's injury or death if they are found negligent.
If you are not sure whether workers' comp is the right choice for your business, click here to learn more.
If you choose to purchase a workers' comp policy, you should:
- Understand your rights and responsibilities in the workers' comp system.
- Speak the language of workers' comp.
- Learn your role in fighting workers' comp fraud, making third-party recoveries, keeping employees safe on the job and helping them return to work when they get injured.
Why Texas Mutual Insurance Company?
We are the state's leading provider of workers' compensation insurance. If you need just one good reason to choose Texas Mutual Insurance Company, we'll give you three...and then some:
- Competitive premiums. Our competitive premiums and discount options make us a money-saving workers' comp solution.
- Health care network. We designed our workers' comp health care network to help injured workers recover and return to productive employment. Eligible employers who choose the network get a 12 percent annual premium discount.
- Comprehensive safety resources. Our loss prevention professionals and interactive online safety tools help policyholders protect their employees and control the costs of on-the-job injuries.
- Focused claim management. Our claim teams focus on getting injured workers well and back on the job.
- Potential dividends. We have paid $850 million in dividends since 1999.*
- Zero tolerance for fraud. Our workers' comp fraud investigators are committed to protecting your premium dollars.
- Versatile coverage options. Our versatile coverage options meet the needs of most Texas businesses, including small businesses.
- Here for Texas. Here to Stay®. Other carries will come and go. Texas Mutual Insurance Company is here for Texas, and we're here to stay.
Need an insurance agent? Visit the Independent Insurance Agents of Texas at www.iiat.org.
*Past dividends are not a guarantee of future dividends, and the Texas Department of Insurance must approve all dividends.
Texas Mutual® online services
Our website is loaded with free, timesaving tools that make it easy for our policyholders to:
To register for complete policyholder access to Texas Mutual® online services, click here.
You can also grant your employees full or limited access to:
- Dividend history
- Loss and claim information
- Class code and payroll information
- Interim reporting
To grant or change employee access levels, send an email to information@texasmutual.com or call our information services center at (800) 859-5995. Your email should include your policy number, the employee's name, and which online information the employee should have accesss to.
Pharmacy help
Texas Mutual Insurance Company partnered with ScripNet to help ensure that your injured workers get the prescriptions they need for their compensable on-the-job injuries.
ScripNet has many pharmacies in Texas, including HEB and Walgreens. Ask your injured workers to present the ScripNet card at any network pharmacy to fill their workers' compensation prescriptions.
To find a network pharmacy, go to www.scripnet.com, or call the ScripNet help desk at (888) 880-8562.