Tag Archive | MSPRC Procedures
SMART Act: Final/Conditional Medicare Lien Process
Looking back at yesterday’s SMART Act post it is hard to decipher how to properly obtain what we are calling a “Final Conditional” Amount or Lien. We hope the following workflow (including our assumptions and expectations of the future process) will help: T-120 days to settlement – Send an Expected Settlement Notice to the MSPRC; […]
SMART Act: Is Medicare Lien Resolution Smarter Now?
On January 10, 2013, President Obama signed H.R. 1845. Included on the Medicare IVIG Access Bill is the SMART Act. SMART was designed to reform the conditional payment, final demand, and MMSEA Section 111 reporting processes. Click here to read the full text of H.R. 1845. As you can see below, we aren’t as excited […]
House & Senate Pass Medicare’s SMART Act
Both the House and Senate passed the SMART act prior to the Christmas holiday last week. In the House just 3 “no” votes were cast against 401 “yes” votes. The Senate passed the act without a single “no” vote. There is little doubt that President Obama will sign the bill into law. What is the […]
AAJ Working Toward 2nd Circuit Allocation of Medicare Lien
The AAJ sent out an update regarding a case where it is attempting to win a major victory for Medicare beneficiaries. The plaintiffs are using Bradley v. Sebelius to try to convince a probate court to allocate the settlement funds and reduce Medicare’s lien. The AAJ writes, In Bradley, the probate court ordered an apportionment […]
LRS Public Comment: CMS-6047-ANPRM – CMS Proposed Rules for Liability Medicare Set-Asides
As you should know, Medicare has taken its first steps toward requiring Medicare Set-Asides in all personal injury cases. On June 15, 2012, it (via CMS and HHS) posted a request for public comment on rules it hastily created for a potential LMSA system. Our initial analysis of the federal register posting from June 15 […]
Medicare Secondary Payer Recovery Portal is Live
The Medicare Secondary Payer Recovery Portal (“MSPRP”) is live and online through MSPRC.info. If you ever tried the automated phone system you know that was a massive failure that could not provide the information you needed. It didn’t really allow you to log complaints, request certain items, check on overdue statuses, etc. So does the […]
Federal Register – June 15, 2012: Advanced Notice of Proposed Rulemaking (LMSAs)
The Friday, June 15, 2012 Federal Register includes a four-page request for public comment requested by the Department of Health and Human Services’ Centers for Medicare & Medicaid Services. The comment is requested for potential changes to 42 CFR Parts 405 and 411 and is titled, “Medicare Program; Medicare Secondary Payer and ‘Future Medicals.’ “ […]
Medicare Case Type Definitions: Liability & No-Fault
The most important part of Medicare lien resolution occurs months (or even years) before you send payment to the MSPRC. That most important process is reporting to the Coordination of Benefits Contractor (“COBC”). If you report the wrong date of incident you risk wasting months of work. If you report the wrong injuries you risk […]
Medicare Conditional Payment Notices
Yesterday I saw more Conditional Payment Notices from Medicare in one day, than I had the entire month of April. Conditional Payment Notices (“CPNs”) are different than Conditional Payment Letters (“CPLs”), but they should not concern you if you know how to respond. This post will discuss what is a CPN, what do to with […]
MSPRC to Introduce Web Portal in Summer 2012
The MSPRC has announced it will release a web portal for conditional payments much like that used for Workers’ Compensation MSAs. From the MSPRC release: Coming Soon – The Medicare Secondary Payer Recovery Portal A new online Self-Service Tool to help manage your Medicare recovery case. The Centers for Medicare & Medicaid Services (CMS) is […]
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