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Announcement
January 20, 2010 - January Group Health Plan Demands
| Message | Date |
|---|---|
| The MSPRC will issue Group Health Plan (GHP) Demands on January 25, 2010. Taking insurer workloads into consideration, an insurer may not receive a demand monthly. This process will increase manageability of GHP demands as well as efficiencies in the GHP Recovery Process for insurers, employers, and the MSPRC.
Please refer to the presentation entitled GHP Process Employers and Insurers/TPAs for more information on the GHP Demands, the GHP Recovery Process, and instructions on submitting a valid documented defense.
For information regarding Group Health Plan Demands sent December 31, 2009 click here. |
Jan 20, 2010 |
January 11, 2010 - Group Health Plan Demands Sent December 31, 2009
| Message | Date |
|---|---|
| On January 5, 2010, the MSPRC identified a system issue that affected a select amount of MSPRC Group Health Plan demands dated December 31, 2009. Some of these demands were generated and mailed on group health plan records that were previously deleted by the Coordination of Benefits Contractor. No demands should have been issued if the record was deleted. If any of your cases are a part of this system issue that caused demands to go out in error, you will NOT need to send in documented defenses; the MSPRC will be adjusting the debt amount and sending a letter advising of the issue and that the matter is resolved.
You will receive a letter within the next two weeks if your cases are a part of this issue. If you do not receive a letter please proceed with the recovery process as normal. If you believe that your demand may have been sent in error and have contacted the Coordination of Benefits Contractor to confirm the group health plan record is accurate, please contact the MSPRC at 1-866-677-7220.
The system issue is being corrected so that this will not occur with the next demands later this month. The MSPRC apologizes for any inconvenience this issue has caused you. |
Feb 27, 2010 |
December 17, 2009 - Group Health Plan Demands
| Message | Date |
|---|---|
| The MSPRC will begin issuing Group Health Plan (GHP) Demands on December 31, 2009 with lower volumes of demands going out monthly. Taking insurer workloads into consideration, an insurer may not receive a demand monthly. This process will increase manageability of GHP demands as well as efficiencies in the GHP Recovery Process for insurers, employers, and the MSPRC.
Please refer to the presentation entitled GHP Process Employers and Insurers/TPAs for more information on the GHP Demands, the GHP Recovery Process, and instructions on submitting a valid documented defense. |
Feb 27, 2010 |
October 01, 2009 – Rights and Responsibilities
| Message | Date |
|---|---|
| Effective for cases established on or after October 1, 2009, the “Right to Recovery Letter” issued when a claim for liability insurance (including self-insurance), no-fault insurance, or workers’ compensation is reported to CMS’ Coordination of Benefits Contractor (COBC) will no longer be issued by the COBC. The letter has been revised, renamed (it is now the “Medicare Secondary Payer Rights and Responsibilities” letter) and will be issued by the MSPRC. Note: If you received a “Right to Recovery Letter” issued by the COBC and dated on or before September 30, 2009, you may follow the instruction in that letter regarding submitting a “Consent to Release” document. |
Feb 27, 2010 |
October 01, 2009 – Proof of Representation
| Message | Date |
|---|---|
| New information is available on this site regarding “proof of representation” and “consent to release” documentation. Please refer to the PowerPoint presentation titled: “Rules and Model Language for ‘Proof of Representation’ vs. ‘Consent to Release’ for Medicare Secondary Payer Liability Insurance (Including Self-Insurance), No-Fault Insurance, or Workers’ Compensation” as well as the pdf. documents with model language. See under the “Proof of Representation” section below. | Feb 27, 2010 |
October 01, 2009 – Interim Conditional Payment
| Message | Date |
|---|---|
| Effective October 1, 2009, the MSPRC will issue information concerning interim conditional payment amounts automatically (that is, without receiving a request for such information) as soon as an interim conditional payment amount is available. If you have an outstanding request for a conditional payment letter (CPL) for a case established prior to October 1, 2009, the request will be processed in the order received. For all new cases, the Medicare beneficiary and any authorized individuals will receive the CPL within 65 days of the issuance of the “Rights and Responsibilities Letter.” Please refer to the discussion in the “Rights and Responsibilities Letter” or the “Rights and Responsibilities Brochure” for further information. | Feb 27, 2010 |
Medicare Secondary Payer Mandatory Reporting
| Message | Date |
|---|---|
| Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (PL 110-173) amends the Medicare Secondary Payer (MSP) provisions of the Social Security Act (Section 1862(b) of the Social Security Act; 42 U.S.C. 1395y(b)) to provide for mandatory reporting for group health plan arrangements, liability insurance (including self-insurance), no-fault insurance, and workers' compensation. The provisions will be implemented January 1, 2009, for information about group health plan arrangements, and July 1, 2009, for information about liability insurance, no-fault insurance, and workers' compensation. If you would like more information about the new Section 111 requirements, please visit www.cms.hhs.gov/MandatoryInsRep. | Oct 1, 2009 |
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