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Coming Soon - The Medicare Secondary Payer Recovery Portal
| Message | Date |
|---|---|
A new online Self-Service Tool to help manage your Medicare recovery case.The Centers for Medicare & Medicaid Services (CMS) is in the process of implementing a new web-based tool designed to assist in and accelerate the resolution of Liability Insurance, No-Fault Insurance, and Workers' Compensation Medicare recovery cases. The new tool is called, The Medicare Secondary Payer Recovery Portal (MSPRP). The MSPRP will give users (attorneys, insurers, beneficiaries, and TPAs) the ability to access and update certain case specific information online. Activities that currently require written communication or telephone calls to the Medicare Secondary Payer Recovery Contractor will soon be able to be done through the portal. The MSPRP will allow users the ability to electronically perform the following activities:
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Apr 10, 2012 |
New Option to Self-Calculate Your Conditional Payment Amount
| Message | Date |
|---|---|
| Effective February 21, 2012, the Centers for Medicare & Medicaid Services (CMS) implemented a new option that allows Medicare, in some cases, to provide a final conditional payment amount before settlement. This option involves beneficiaries and/or their representatives self-calculating the final conditional payment amount. If the eligibility criteria are met, this option is best exercised when you have a current conditional payment letter from the MSPRC and you are nearing settlement of the case.
Refer to either the Attorney or Medicare Beneficiary Tool Kit for Self-Calculated Conditional Payment Amount Information (including an example submission package) and Model Language. |
Apr 12, 2012 |
New Fixed Percentage Option For Medicare's Recovery Claim
| Message | Date |
|---|---|
| Effective November 7, 2011, the Centers for Medicare & Medicaid Services has implemented a new and simple fixed percentage option that is available to certain beneficiaries. This option is available to beneficiaries who receive certain types of liability insurance (including self-insurance) settlements of $5000 or less.
A full explanation, including instructions on how and when to elect this option, is available in the Fixed Percentage Option section of both the Attorney and Beneficiary Toolkits. |
Apr 10, 2012 |
Beneficiary Alert: $300 Threshold on Liability Settlements
| Message | Date |
|---|---|
| Medicare has implemented a $300 threshold for certain Liability Insurance cases. If all of Medicare's criteria are met, the MSPRC will not recover against the beneficiary's settlement, judgment, award or other payment.
We have posted a detailed explanation in the Attorney and Insurer Toolkits. |
Apr 10, 2012 |
ALERT - Liability Insurance (Including Self-Insurance) and December 5, 1980 (12/5/1980)
| Message | Date |
|---|---|
| Additional policy details have been provided by the Centers for Medicare & Medicaid Services on liability insurance (including self-insurance) cases involving exposure, ingestion, and implantation.Click here to view the update. | Apr 10, 2012 |
January 20, 2010 - January Group Health Plan Demands
| Message | Date |
|---|---|
The MSPRC will issue Group Health Plan (GHP) Demands on January 25, 2010. Taking insurer workloads into consideration, an insurer may not receive a demand monthly. This process will increase manageability of GHP demands as well as efficiencies in the GHP Recovery Process for insurers, employers, and the MSPRC. Please refer to the presentation entitled GHP Process Employers and Insurers/TPAs for more information on the GHP Demands, the GHP Recovery Process, and instructions on submitting a valid documented defense. For information regarding Group Health Plan Demands sent December 31, 2009 click here. |
Mar 2, 2012 |
ALERT - Group Health Plan Demands
| Message | Date |
|---|---|
| The MSPRC will begin issuing Group Health Plan (GHP) Demands on December 31, 2009 with lower volumes of demands going out monthly. Taking insurer workloads into consideration, an insurer may not receive a demand monthly. This process will increase manageability of GHP demands as well as efficiencies in the GHP Recovery Process for insurers, employers, and the MSPRC.
Please refer to the presentation entitled GHP Process Employers and Insurers/TPAs for more information on the GHP Demands, the GHP Recovery Process, and instructions on submitting a valid documented defense. |
Jan 22, 2010 |
ALERT – Rights and Responsibilities
| Message | Date |
|---|---|
| Effective for cases established on or after October 1, 2009, the “Right to Recovery Letter” issued when a claim for liability insurance (including self-insurance), no-fault insurance, or workers’ compensation is reported to CMS’ Coordination of Benefits Contractor (COBC) will no longer be issued by the COBC. The letter has been revised, renamed (it is now the “Medicare Secondary Payer Rights and Responsibilities” letter) and will be issued by the MSPRC. Note: If you received a “Right to Recovery Letter” issued by the COBC and dated on or before September 30, 2009, you may follow the instruction in that letter regarding submitting a “Consent to Release” document. |
Jan 22, 2010 |
ALERT – Proof of Representation
| Message | Date |
|---|---|
| New information is available on this site regarding “proof of representation” and “consent to release” documentation. Please refer to the PowerPoint presentation titled: “Rules and Model Language for ‘Proof of Representation’ vs. ‘Consent to Release’ for Medicare Secondary Payer Liability Insurance (Including Self-Insurance), No-Fault Insurance, or Workers’ Compensation” as well as the pdf. documents with model language. See under the “Proof of Representation” section below. | Jan 22, 2010 |
ALERT – Interim Conditional Payment
| Message | Date |
|---|---|
| Effective October 1, 2009, the MSPRC will issue information concerning interim conditional payment amounts automatically (that is, without receiving a request for such information) as soon as an interim conditional payment amount is available. If you have an outstanding request for a conditional payment letter (CPL) for a case established prior to October 1, 2009, the request will be processed in the order received. For all new cases, the Medicare beneficiary and any authorized individuals will receive the CPL within 65 days of the issuance of the “Rights and Responsibilities Letter.” Please refer to the discussion in the “Rights and Responsibilities Letter” or the “Rights and Responsibilities Brochure” for further information. | Jan 22, 2010 |
Medicare Secondary Payer Mandatory Reporting
| Message | Date |
|---|---|
| Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (PL 110-173) amends the Medicare Secondary Payer (MSP) provisions of the Social Security Act (Section 1862(b) of the Social Security Act; 42 U.S.C. 1395y(b)) to provide for mandatory reporting for group health plan arrangements, liability insurance (including self-insurance), no-fault insurance, and workers' compensation. The provisions will be implemented January 1, 2009, for information about group health plan arrangements, and July 1, 2009, for information about liability insurance, no-fault insurance, and workers' compensation. If you would like more information about the new Section 111 requirements, please visit www.cms.hhs.gov/MandatoryInsRep. | Oct 1, 2009 |