WCRC Transition to be Seamless and Promising

CMS, Medicare Set-Aside Blog, Medicare Set-Asides, MSP News, WCRC on March 7, 2018 | Posted by Jean S. Goldstein, JD

CMS and Capitol Bridge LLC, the entity taking over as the new Workers’ Compensation Review Contractor (WCRC) held a webinar today regarding the planned WCRC transition.  CMS introduced Capitol Bridge, who categorically addressed concerns regarding the transition.  It was quite clearly stated that today’s webinar would not address any policy questions, but simply address transition questions and concerns.  While the question of Liability Medicare Set-Asides (LMSAs) arose during the call, because this call was specifically regarding the transition to the new WCRC, LMSAs were not discussed in any detail, and deemed a policy question.

Our main takeaways from the call:

  • The transition is expected to be seamless;
  • Capitol Bridge has employed a staff of nurses, physicians, attorneys and administrative staff that are well versed in the Workers’ Compensation Medicare Set Aside submission process;
  • All nurse reviewers are also Medicare Set-Aside Certified Consultants;
  • The portal will not be effected by this transition, when the current WCRC, Provider Resources, ceases production on 03/16/18, and Capitol Bridge starts on 03/19/18;
  • Calculation methodologies of WCMSAs will not change;
  • Contact information as of 03/19/2018 will be as follows:

While CMS and Capitol Bridge reinforced that they do not expect any backlog, each indicated that review of a WCMSA submission should be completed within 20 days, if no development has been issued.  CMS did note that at present, many cases come back sooner than 20 days; however, 20 days is the specified time frame that a case must be reviewed as provided within the Statement of Work.  We would expect this 20 day turnaround time to be the norm, as Capitol Bridge becomes more fully immersed in the WCMSA review process.

Lastly, one point mentioned on the call that has peaked our interest, is Capitol Bridge’s willingness to automate the WCMSA review process as much as possible.  Specifically, Capitol Bridge indicated that the “sky is the limit” but one major focus at this time would be to ensure that there are no double coding/errors made.  This is certainly a promising endeavor and we look forward to seeing where Capitol Bridge takes us.

The webinar will be available for download here shortly.