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CMS Clarifies Prior TPOC Alert in an Update to the NGHP User Guide

  • 12/28/21
  • Brendon De Souza


On December 20, 2021, the Centers for Medicare & Medicaid Services (CMS) updated the NGHP User Guide (Chapter III: Policy Guidance) to incorporate a prior Total Payment Obligation to Claimant (TPOC) alert into CMS’ formal policy guidance. CMS has established the following bright-line rule for timely reporting TPOCs:  6.5.1.2 Timeliness of Reporting NGHP TPOC settlements, judgments, awards, or other payments are reportable once the following criteria are met:  The ...

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