CMS Releases FAQ Document Regarding the Commercial Repayment Center Non-Group Health Plan Recovery Workload Transition

CMS, Conditional Payments, Mandatory Insurer Reporting, Medicare, Medicare Set-Aside Blog on October 27, 2015 | Posted by Erin O'Neill, PA-C, JD

On October 26, 2015, the Centers for Medicare and Medicaid Services (CMS) released a Frequently Asked Questions (FAQ) Document in order to provide information regarding the transition of a portion of the Non-Group Health Plant (NGHP)Medicare Secondary Payer (MSP) recovery workload from the Benefits Coordination & Recovery Center (BCRC) to the Commercial Repayment Center (CRC). While no new information was presented, the question and answer format served to clarify the procedural changes discussed in the prior webinars.

Topics covered in the FAQ document include: 1) under what circumstances the BCRC and CRC should be contacted, 2) when CMS pursues recovery from a beneficiary versus an applicable plan, 3) when CMS issues a Conditional Payment Notice (CPN) versus a Conditional Payment Letter (CPL), 4) how an Applicable Plan can appoint a Recovery Agent to work with the CRC and BCRC, 5) when an Applicable Plan can appeal a CRC demand letter, 6) when CMS may issue multiple demand letters from the CRC, 7) when CMS may issue zero CPNs/CPLs, and 8) the means by which CMS identifies conditional payments.

The FAQ Document can be downloaded from the Coordination of Benefits and Recovery Overview What’s New page on CMS.gov.

https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Coordination-of-Benefits-and-Recovery-Overview/Whats-New/Whats-New.html