Upcoming Enhancement to the Functionality of the Medicare Secondary Payer Recovery Portal

CMS, Conditional Payments, Mandatory Insurer Reporting, Medicare, Medicare Set-Aside Blog on November 13, 2015
Posted by Erin O'Neill, PA-C, JD

The Centers for Medicare and Medicaid Services (CMS) has announced that the Medicare Secondary Payer Recovery Portal (MSPRP) will be updated to include functionality for obtaining a final conditional payment amount on those cases that are 120 days or less from an anticipated settlement. As part of the Strengthening Medicare and Repaying Taxpayers Act of 2013, these enhancements will be functional by January 1, 2016.

Authorized users will be able to notify CMS that a settlement is pending and request that the final conditional process be initiated utilizing the MSPRP. Any disputes submitted through the MSPRP will be resolved within in 11 days. Once any disputed charges have been resolved and the case is within 3 days of settling, a final conditional payment amount may be requested utilizing the MSPRP. This amount will remain the final conditional payment amount as long as the case settles within 3 days and the final settlement information is submitted through the MSPRP within 30 days.

The announcement can be viewed on the Coordination of Benefits and Recovery Overview What’s New page on CMS.gov.