MSPRC running behind on conditional payment requests
With the flood of conditional payment letters soon to be generated by MMSEA Section 111 reporting, the MSPRC is proactively falling behind. Although their stated goal is to respond to conditional payment inquiries within 67 days, we are seeing three months or longer as the norm. Expect this delay to be magnified early next year when RREs begin to report live production files.
This issue can be frustrating for third-party liability payers and plaintiff attorneys because the “Medicare lien” needs to be resolved as a term of the settlement. Best practice today dictates getting as far in front of the curve as possible when requesting conditional payment information as part of a proposed settlement. And be sure to follow up diligently because it is not uncommon for the MSPRC to magically lose an inquiry and have to start the process from day one.