EMPLOYER VOLUNTARY DATA SHARING AGREEMENT (VDSA)Medicare Secondary Payer • January 6th, 2022
This Voluntary Data Sharing Agreement (the “Agreement”) for the exchange of health care coverage enrollment information is entered into between [insert Employer name] and related entities as identified herein, a [insert State name if appropriate] Corporation, with its principal address at [insert Employer address] (the “Employer”) and the United States Department of Health and Human Services, acting by and through the Centers for Medicare & Medicaid Services (“CMS”) (together, the “Parties”) on this day of , 20 (the “Effective Date”).
INSURER VOLUNTARY DATA SHARING AGREEMENTMedicare Secondary Payer • April 23rd, 2008
This Voluntary Data Sharing Agreement (the "Agreement") for the exchange of health care coverage enrollment information is entered into between [insert Insurer name] and related entities as identified herein, a [insert State name if appropriate] Corporation, with its principal address at [insert Insurer address] (the "Insurer") and the United States Department of Health and Human Services, acting by and through the Centers for Medicare & Medicaid Services ("CMS") (together, the "Parties") on this day of , 20 (the "Effective Date").
