New MSPRC Procedures for Medicare Liens

The MSPRC webinar of April 14, 2010 includes one important new addition to the Medicare lien resolution process.

Conditional Payment Notice

The Conditional Payment Notice replaces a standard Conditional Payment Letter in the following situations:

  1. Where the MSPRC learns of a beneficiary’s case through Section 111 reporting, and where the plaintiff has not reported settlement.  Keep in mind mandatory reporting does not begin until October 1, 2010, however, permissive reporting remains in effect now.
  2. Where settlement occurs prior to the issuance of a Conditional Payment Letter, or where settlement is reported concurrent with initial COBC reporting.

Most important, if the beneficiary or his agents fail to respond to a Conditional Payment Notice within 30 days, the MSPRC may issue a Final Lien Demand.  This demand will not take into account plaintiffs’ attorneys’ costs or fee – because the MSPRC will not have that information.  Additionally, your Medicare negotiation ability will be limited.  Failure to respond will lead to a waiver of dispute privileges (but note that you will still be able to appeal a lien using the same arguments you would have in dispute).

Obviously, the Conditional Payment Notice can be dangerous if ignored.  Interest will begin to accrue on a larger-than-necessary lien just 90 after the Conditional Payment Notice is sent.  Plaintiffs’ attorneys could begin to see these letters as Section 111 Mandatory Reporting begins on October 1, 2010.

Your best defense in a Conditional Payment Notice situation is to act quickly.  A lien resolution provider can audit and dispute a Medicare lien in as little as a day.  Or, you can simply avoid the Conditional Payment Notice by staying on top of the process.  Report your case to the COBC early.  This will allow you multiple dispute opportunities and prevent an unrequested Final Demand Letter.  It will keep you in control.

Contact Lien Resolution Services if you need help with any healthcare liens.

Ryan J. Weiner
Co-Founder Lien Resolution Services
This Blog/Web Site is made available by the publisher for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog site you understand that there is no attorney client relationship between you and the Blog/Web Site publisher. The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.

About Ryan J. Weiner

Co-Founder of Lien Resolution Services, LLC, a national healthcare lien resolution firm. Our goal is to assist in the fair administration and resolution of healthcare liens on personal injury cases. Please visit our website for more information: www.lienresolutionusa.com.

3 comments on “New MSPRC Procedures for Medicare Liens

  1. […] Lien Resolution Services – Healthcare Lien Resolution Blog News and Analysis of the Latest in Subrogation « New MSPRC Procedures for Medicare Liens […]

  2. […] MSPRC purpose for this meeting includes education on the New Conditional Payment Notice and Process, as well as updates […]

  3. […] appropriately (and timely) notifying the MSPRC of settlement.  If you do not, you may run into the Conditional Payment Notice situation, where costs/fees may not go into the reduction.  Remember, it takes just 2-3 weeks to […]

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