Updates to Medicare Secondary Payer Recovery Portal

The Medicare Secondary Payer Recovery Portal (MSPRP) is a tool developed by CMS several years ago to allow for online access to their recovery processes.   On Thursday August 16th, CMS hosted a Medicare Secondary Payer Recovery Portal (MSPRP) Overview Webinar to discuss some recent enhancements to the system.

To reduce the number of calls that they receive regarding the status of their cases, one of the improvements made is the new “Letter Activity” tab.  This tab allows insurers and their authorized representatives the ability to view the status of their incoming and outgoing correspondence on cases.

Another new feature allows both the insurers and beneficiaries (and their representatives) the ability to now request electronic letters including Electronic Conditional Payment Letters (e-CPL).

NuQuest looks forward to utilizing these enhancements to assist our clients in what we are hopeful will be a more efficient conditional payment recovery process and will continue to monitor the efficiency and accuracy of these recent changes.

Recap of Capitol Bridge LLC’s WCRC Transition Webinar

The new WCRC, Capitol Bridge presented a short transition webinar this afternoon.  The main presenters were Holly Havens of Capitol Bridge and  John Jenkins of CMS. Ms. Havens stressed the group’s 25 years of experience in providing various support services to CMS.  The group intends to maintain the same level of quality and timeliness with processing the files. According to their Statement of Work, development letters, if any, will be sent out within the first 10 business days after receipt of the CMS submission. Determinations will be issued within 20 business days after the complete submission is received.   Files that are currently pending will be transferred over to Capitol Bridge as of March 19, 2018, their first full day. There will be no change to CMS’ projection methodology.

Customer service will be handled by Capitol Bridge’s staff in Pittsford, New York. The preferred method of contact is by telephone, (833) 295-3773 or by email at WCRC@capitolbridgellc.com. All forms of communication must include the claim’s specific case number. Claims should continue to be submitted through the portal and to the same mailing address in Oklahoma. Capitol Bridge’s fax number is (585) 425-5390.

A question and answer session included questions regarding possible liability and no-fault MSA review. John Jenkins declined to address these during this call. Other questions focused on a concern about a backlog given the transition and the qualifications of Capitol Bridge’s reviewers. No backlog was anticipated by Capitol Bridge. Their review staff was also described as experienced MSA nurse reviewers, MSP compliance attorneys, physicians, and pharmacists. Capitol Bridge’s goal is to automate as much of the process as possible to avoid double keying of information and better coordinate the exchange of data between various systems. The portal user interface will not change as a result of the transition.  Capitol  Bridge also indicated that their 20 business day turn-around time should also apply to the amended review process. This presentation will also be available in the near future on CMS’ “What’s New” section on their website.

We will continue to keep you advised of further developments.

CMS Upcoming WCRC Webinar

CMS just announced its plan to host a webinar on March 7th, 2018 at 1:00 pm ET to introduce the new WCRC Contractor. The new contractor, Capitol Bridge LLC,  is expected to assume responsibilities on March 18, 2018. Registration and webinar login URL is https://engage.vevent.com/index.jsp?eid=5779&seid=863 with a conference call number of  877-251-0301, conference ID 9369188.

We will keep you advised of further developments.

October 24, 2017 – Consideration for Expansion of Medicare Set-Aside Arrangements (MSA)

The Centers for Medicare and Medicaid Services (CMS) continues to consider expanding its voluntary Medicare Set-Aside Arrangements (MSA) review process to include liability insurance (including self-insurance) and no-fault insurance MSA amounts. CMS will work closely with the stakeholder community to identify how best to implement this potential expansion of voluntary MSA reviews. Please continue to monitor this website for updates and announcements of town hall meetings in the near future.