Medicare Secondary Payer (MSP)

2/27/2019 - 1 min read

Electronic payment functionality to be added to the Medicare Secondary Payer Recovery Portal – CMS to hold webinar on March 13, 2019

CMS announced effective April 1, 2019, electronic payment functionality will be added to the Medicare Secondary Payer Recovery Portal.

2/25/2019 - 1 min read

CMS to mask health insurance claim number and social security number on contractor correspondence starting April 2019

Starting 4/1/19, CMS’s Coordination of Benefits and Recovery Program program will mask the social security number (SSN) and SSN-portion of the health insurance claim number on all ongoing letters.

1/2/2019 - 1 min read

Government shutdown – MSP update

As the partial government shutdown continues, questions are being raised as to the shutdown’s impact on CMS activities concerning Medicare Secondary Payer compliance.

Linkedin Sales Navigator H5cptwuvhm Unsplash

12/21/2018 - 2 min read

Proposed rules for addressing future medical obligations to be released

The Office of Information and Regulatory Affairs (OIRA) recently issued a notice entitled Miscellaneous Medicare Secondary Payer Clarifications and Updates (CMS-6047-P). This notice indicates that the Centers for Medicare and Medicaid Services (CMS) plans on issuing proposed rules regarding options to address future medicals in relation to liability, workers’ compensation and no-fault cases.

12/20/2018 - 3 min read

MSPRP update: CMS announces a new self-reporting option and updates to the multi-factor authentication process

The Centers for Medicare and Medicaid Services (CMS) hosted a webinar focusing on enhancements to its Medicare Secondary Payer Recovery Portal (MSPRP) on December 18, 2018.

10/24/2018 - 7 min read

CMS updates its Medicare prescription drug benefit manual – New changes encourage Part D collection and recovery

The Centers for Medicare and Medicaid Services (CMS) has amended its Medicare Prescription Drug Benefit Manual (Part D Manual) to add, in part, stronger language regarding Medicare Part D sponsors’ secondary payer rights and recovery.

8/17/2018 - 1 min read

CMS hosts Medicare Secondary Payer Recovery Portal (MSPRP) Webinar

On August 16, 2018, the Centers for Medicare and Medicaid Services (CMS) hosted a webinar focusing on its Medicare Secondary Payer Recovery Portal (MSPRP).

8/14/2018 - 6 min read

Drug formularies continue to expand in workers’ comp systems

Balancing rising medical and pharmaceutical costs with appropriate and timely treatment for injured workers has been an ongoing struggle for workers’ compensation professionals. But recent trends indicate a positive change for the industry.

Glenn Carstens Peters Npxxwgq33zq Unsplash

7/12/2018 - 2 min read

Minor changes in newly released Medicare Secondary Payer Recovery Portal User Guide

The Centers for Medicare and Medicaid Services (CMS) has released an updated version of its Medicare Secondary Payer Recovery Portal (MSPRP) User Guide (Version 4.2). The changes are minor and primarily aimed at streamlining the communication process when requesting conditional payment information.

6/20/2018 - 4 min read

Law firm reaches settlement with U.S. Department of Justice to reimburse Medicare conditional payments and start internal MSP compliance program

The United States Department of Justice (DOJ) for the Eastern District of Pennsylvania has issued a news release reporting that a Philadelphia personal injury law firm has agreed to pay the government $28,000.00 to resolve allegations that the firm failed to reimburse Medicare conditional payments, and agreed to start an internal compliance program to ensure timely repayment of conditional payments going forward.

6/8/2018 - 8 min read

Court denies “double damages” under the MSP’s private cause of action

Currently, there are two questions being litigated that involve who can sue under the Medicare Secondary Payer’s (MSP) private cause of action (PCA) provision and when “double damages” may apply.

3/19/2018 - 7 min read

Medicare Advantage update: Connecticut court rules MAPs can pursue “double damages” under the Medicare Secondary Payer statute

Connecticut is the latest jurisdiction to address whether MAPs have private cause of action (PCA) rights to pursue “double damages” under the MSP statute.

2/28/2018 - 7 min read

Medicare watch list: Staying ahead of the Medicare Secondary Payer compliance curve

As another new year settles in, we know at least one thing is certain: MSP compliance will continue to present formidable challenges for claims payers.

1/23/2018 - 1 min read

Government shutdown ends – Congress and President reach deal

This brief government shutdown did not affect Medicare Secondary Payer operations as they are essential and considered part of the Medicare Integrity Program. Thus, operations at the applicable MSP contractors, including the WCRC, CRC and BCRC continued as normal during the shutdown.

1/22/2018 - 1 min read

Government shutdown & Medicare Secondary Payer impact

Medicare Secondary Payer operations will not be affected as they are essential and considered part of the Medicare Integrity Program. However, were are receiving word that an increasing number of Social Security Administration offices across the country will not be fulfilling requests for benefits verification by third-parties during the shutdown.