Leave a comment

Is There a New MSPRC Contractor on Deck?

Rumors are circulating throughout the Medicare lien world that the current Medicare Secondary Recovery Contractor is being replaced.  Chickasaw Nation Industries has acted as the contractor since 2006, but its contract expires at the end of September 2011.

The AAJ has also reported on these upcoming changes, including a member-wide email from AAJ President Linda Lipsen sent September 20, 2011:

Dear Colleagues,

AAJ Public Affairs is working steadily on solutions to create certainty, finality and proportionality in the reimbursement process when your clients are Medicare beneficiaries.

This is a long road that started more than two years ago. Last year, the Centers for Medicare & Medicaid Services (CMS) announced a one-year delay in Medicare Secondary Payer (MSP) liability reporting requirements so that they could work on improving the process. More recently, AAJ anticipates that CMS will announce a series of policy changes that will be implemented over the coming months. These policy changes should have a positive impact on the amount of time it takes to resolve an MSP reimbursement claim as well as provide some certainty in the process.

In addition, CMS will likely issue guidance this week regarding Medicare beneficiaries with exposure or ingestion claims, in particular, claims that occurred prior to 1980 [LRS ed. – the effective year of MSP]. We are hopeful that this guidance will, in part, address some of the issues that many of you have had settling exposure claims involving a Medicare beneficiary. As soon as this guidance is finalized and we have a better understanding of its contents, we will let you know. As always, if there are any concerns we will address them with policy makers accordingly.

Progress is being made, and we will continue to advocate for program changes until the system is running smoothly.

Many of you know that in addition to our work with CMS, AAJ is also advocating for a bipartisan bill, H.R. 1063, the Strengthening Medicare and Repaying Taxpayer Act (SMART Act) that pushes a number of changes, including requiring CMS to provide the amount of conditional payment prior to settlement.

MSP issues are important to you and your clients and we are actively tracking this fluid situation; it has been changing week-to-week for several months. We will keep you updated as soon as we hear more.

Best Regards,

Linda Lipsen
Chief Executive Officer
American Association for Justice

In addition to the AAJ news, it has become apparent that Group Health Incorporated will act as the interim MSPRC contractor handling Medicare liens while the bidding process continues.  Industry representatives may recognize Group Health Incorporated as the entity acting as Medicare’s Coordination of Benefits Contractor (COBC) since 1999.  Perhaps this short term change can assist in the COBC to MSPRC transfer process (MSPRC represenatives often tell our specialists, “the COBC must not have transferred that to us”).  Keep in mind CMS representatives have indicated this is not a permanent change.  Group Health Inc. is not taking over the MSPRC contract, it has not won an MSPRC contract.  We don’t even know if it is involved in the MSPRC bidding process.

We do know that CMS representatives believe the MSPRC bidding process will be completed and a new MSPRC contract will be awarded sometime in the Spring of 2012.  Finally, we must repeat that much of this information is the product of internet rumor – we cannot guarantee the MSPRC process will occur exactly as described in this post.

Does this mean good things for Medicare liens?  Perhaps the process will be smoother, simpler, and most important: faster.  Perhaps.

If you need assistance with Medicare liens, Medicaid liens, ERISA liens, or any other healthcare liens, contact LRS.  LRS can help resolve all healthcare liens.  Please contact us for more information.


Ryan J. Weiner
Co-Founder Lien Resolution Services
Twitter: @LienResolve
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.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )


Connecting to %s

%d bloggers like this: