MSPRC Contract Expires and Will Not be Renewed

We have confirmed with CMS that the MSPRC contract which has been held by Chickasaw Nation Industries (CNI) since 2006 will not be renewed when it expires on September 30, 2011.  CMS is seeking to establish a centralized and streamlined Coordination of Benefits (COBC) and Medicare Secondary Payer Recovery (MSPRC) operation by consolidating the two units and creating the Medicare Secondary Payer Integration Contractor (MSPIC).  CMS posted a source sought notice on August 24, 2011 for the MSPIC. To view this posting click here

In the interim, the MSPRC has confirmed that Group Health Incorporated (GHI) will be overseeing the recovery process and is already on site working through the transition with the MSPRC.  It is expected that this transition may be a result of the recent hearing before the Oversight and Investigation Subcommittee in June where the conditional payment recovery process and the administrative fees required to recover debts were called into question. This change could lead to additional administrative and/or policy changes in regard to conditional payment recovery.  Changes in the recovery process were initiated earlier this month when the MSPRC announced the implementation of a $300.00 threshold where Medicare will not recover conditional payments for liability claims if certain criteria are met.   For additional details on the liability recovery threshold please click here to review our blog post regarding this subject. 

PMSI is also hopeful that this transition will lead to an improvement in the length of time it takes to verify and resolve conditional payments which would be welcomed by the industry.  We will continue to monitor this transition and post additional information as it is received.

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