The Centers for Medicare and Medicaid Services recently held a high-level overview webinar of the upcoming Medicare Secondary Payer Recovery Portal (MSPRP) enhancements.

Jean S. Goldstein

The purpose of the webinar was to update MSPRP users regarding the ability to self-report a Non-Group Health Plan (NGHP) lead through the MSPRP.  Self-reporting is when a Medicare secondary payer case is reported by a beneficiary or a representative, or when an insurer or insurer representative is reporting a case that may not be appropriate to report via Section 111 reporting.

It is important to note that this new self-reporting feature should not be used when ongoing responsibility for medical (ORM) has been accepted or a settlement has been reached. 

As it stands now, Medicare beneficiaries, insurers, recovery agents, attorneys or other authorized representatives have the ability to self-report a new NGHP MSP case to the Benefits Coordination & Recovery Center (BCRC) either by calling the BCRC or providing written correspondence to BCRC.

In January, MSPRP users will be able to use the portal to report the MSP case rather than contacting the BCRC directly. If an MSPRP user has accepted ORM or already reached a settlement, the system will alert the user that the case he is attempting to report cannot be created in the MSPRP.

MSPRP users should be aware that a conditional payment letter (CPL) will automatically be mailed to the beneficiary and all authorized parties, after the self-reported MSP lead has been created and completed. If a settlement has been reached for the submitted case, a conditional payment notice will be mailed instead of the CPL.

The webinar also addressed the current multi-factor authentication process, which provides MSPRP users with the ability to view unmasked case information in the portal.  The current MFA process is being replaced with a new MFA solution provided by OKTA. 

Current MFA users will no longer be able to use the existing MFA process, and instead will be offered an MFA method of either a voice call or text message. This new process will be effective after Jan. 5, 2019, and must be utilized in order to see the unmasked case information.

If an MSPRP user does not complete this new MFA process, he will still be able to access the associated account information but will not have complete case information.  CMS concluded the webinar advising that in the spring, the portal will also support electronic payment options, as we previously advised.

The most important consideration we would like to leave you with from the webinar is that if you are reporting an MSP lead, it is extremely important that you accurately report ICD codes. By accurately reporting the associated diagnosis codes, you are mitigating possible future exposure down the road.

Jean S. Goldstein is senior legal counsel for Medval. This post from the Medval blog is republished with permission.