Develop ESRD Claims Where Basis for Medicare Entitlement Changes

30.3.1 - Develop ESRD Claims Where Basis for Medicare Entitlement Changes (Rev. 11550; Issued: 08-12-22; Effective: 10-13-22; Implementation:10-13-22) Medicare is the secondary payer throughout the entire 30-month ESRD coordination period when a beneficiary is eligible for, or entitled to, Medicare on the basis of ESRD. If the beneficiary becomes disabled or aged before the coordination period ends, see Chapter 2, §20.1.3, of this manual. To assist A/B MACs and DME MACs in processing claims under these provisions, the MSP Contractor determines the coordination period based upon information it develops, and updates the CWF (See Chapter 3). A/B MACs and DME MACs are encouraged to use the End-Stage Renal Disease Quality Reporting System (EQRS)to determine and enter the correct ESRD COB period. However, A/B MACs and DME MACs are permitted to show the actual or default effective date without an end date. If the A/B MACs and DME MACs enter the end date, it is held accountable for entering the correct COB period. Note: To begin the process of gaining access to EQRS, please have the requestor submit a ticket to the Quality Net Help Desk, information below. The staff there will be able to walk the user through the process, which begins with establishing a CMS EIDM account: QualityNet Help Desk, CROWNWEB/ EQRS Systems, phone: (866) 288-8912, Fax (888) 329- 7377, email: qnetsupport-esrd@hcqis.org