From www.MSPRC.info:

Beneficiary Alert: $300 Threshold on Liability Settlements

Medicare has implemented a $300 threshold for certain Liability Insurance cases. If all of Medicare’s criteria are met, the MSPRC will not recover against the beneficiary’s settlement, judgment, award or other payment.

If you’re a beneficiary, what does this mean for you?

As of September 6, 2011, if you’ve received a lump sum settlement of $300 or less, and your case meets certain conditions, Medicare will not recover from that settlement. These conditions include:

1. Your settlement is related to an alleged physical trauma-based incident, not an alleged exposure, ingestion, or implantation, and
2. You do not have any additional settlements related to the same alleged incident.

Please note that this threshold specifically excludes settlements where an insurer is paying your medicals bills directly or on an ongoing basis. This threshold also does not apply if a demand letter was already issued for your case. We have posted a more detailed explanation in the Attorney and Insurer Toolkits.

For more information on the $300 MSPRC Threshold, Medicare Secondary Payer, or any lien resolution issue, feel free to contact Lien Settlement Solutions at info@lienss.com or by phone, (877)907-5436 extension 2. 

We are the Lawyers Solution to Lien Resolution!

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MEDICARE Secondary Payer Final Demand letters will resume on 6/27/2011, according to www.msprc.info.  A review of the Rights & Responsibilities and Final Demand letters are complete. 

From www.MSPRC.info

ALERT UPDATE: Review of the Rights and Responsibilities letter and the Demand Letters is complete

Review of the Rights and Responsibilities letter (“RAR”) and the Demand Letters for liability insurance (including self-insurance), no-fault insurance and workers’ compensation is complete. Issuance of the RAR resumed on June 10, 2011. A copy of the revised RAR is now available on this website. Issuance of the affected Demand letters is anticipated to resume June 27, 2011. Copies of the revised Demand letters will be made available by that time on this website.

For more information on the Final Demand letter, Medicare Secondary Payer, or any lien resolution issue, feel free to contact Lien Settlement Solutions at info@lienss.com or by phone, (877)907-5436. 

We are the Lawyers Solution to Lien Resolution!

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For up to the minute updates on Medicare, Medicaid, ERISA and other lien resolution developments, follow Lien Settlement Solutions on Twitter @LienSS_Tevra! 

Tevra Johnson, Director of Lien Resolution and Medicare Compliance shares tips, news, and facts about subrogation, reporting, compliance, and everything in between.  For more information about Lien Settlement Solutions and our services, contact us at info@lienss.com, or by phone at (877)907-5436.

From www.msprc.info

ALERT UPDATE: Issuance of the Demand letters is temporarily suspended – Review of the Rights and Responsibilities letter is complete

The Demand letter for liability insurance (including self-insurance), no-fault insurance and workers’ compensation has been temporarily suspended while this letter is under review. The MSPRC is still working cases, and Demand letters will be mailed out once this review is complete. Review of the Rights and Responsibilities letter (“RAR”) is complete. Issuance of the RAR is anticipated to resume on June 10, 2011. A copy of the revised RAR will be made available by that time on this website.

Lien Settlement Solutions will continue to provide updates as soon as new information is received regarding this and any other Medicare Resolution issue.  For more information on how Lien Settlement Solutions can assist your firm, please contact us at info@lienss.com, or by calling (877)907-5436.

The Medicare Secondary Payer Recovery Contractor has issued an alert on their website, www.msprc.info, notifying of a temprorary suspension of the issuance if Final Demand and Rights and Responsibilities letters. 

“News and Updates

Alert: Issuance of the Rights and Responsibilities (RAR) and Demand letters has been temporarily suspended

Issuance of the Rights and Responsibilities (“RAR”) and Demand letters has been temporarily suspended while these letters are under review. The MSPRC is still working cases, and the RAR and Demand letters will be mailed out once appropriate revisions have been made. ” From www.msprc.info.

Jason D. Lazarus, Esq, CEO of Synergy Settlement Services has written a complete explanation on the MSPRC suspensions, and the recent  Haro v. Sebelius decision in Arizona.  CLICK HERE to learn more about this matter.

Lien Settlement Solutions will continue to provide updates as soon as new information is received regarding this and any other Medicare Resolution issue.  For more information on how Lien Settlement Solutions can assist your firm, please contact us at info@lienss.com, or by calling (877)907-5436.

December 1, 2010

The following documents have been posted to the NGHP Alerts section page:

• MMSEA 111 – Alert – November 18, 2010 – ALERT: Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers’ Compensation – Special Default ICD-9 Code for Responsible Reporting Entities (RREs).
• MMSEA 111 – Alert – November 18, 2010 – ALERT:  TIN Reference File Address Validation Information for Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers’ Compensation Responsible Reporting Entities (RREs).

The following documents have been posted to the GHP Alerts section page:

• ALERT – November 19, 2010 – New COB MSP Hierarchy Rules or for Group Health Plan (GHP) Responsible Reporting Entities (RREs).
• ALERT – November 18, 2010 – TIN Reference File Address Validation Information for Group Health Plan (GHP) Responsible Reporting Entities (RREs).

 If you have any questions concerning MMSEA Section 111 or MSP compliance,  please contact Erica Cooper, Manager of Medicare Services and Compliance with Lien Settlement Solutions, LLC. at 877.907.LIEN (5436) or by e-mail at ecooper@lienss.com.

CMS has revamped the Medicare recovery process, creating a more efficient and less questionable path for the verification of Medicare conditional payments.  Based on a compilation of facts from www.MSPRC.info,  Medicare Correspondence, and daily interaction with MSPRC,  we have created a timeline to a serve as a general guide to the Medicare Resolution Process,  and what can be expected by all parties entering a settlement with a possible Medicare obligation. 

 The following is an approximate timeline for the Medicare recovery process*:

1. Day 1:  Report to Coordination of Benefits Contractor (COBC) by calling 1(800)999-1118.
2. Day 2 – 12:  The case is transferred to the Medicare Secondary Payer Contractor (MSPRC) from the COBC within 2 weeks.
3. Day 14-21:  Within (7) days of the record being created in the MSPRC’s database, a Rights and Responsibility (RAR) letter will be sent to the beneficiary and their attorney.
4.  The MSPRC will begin their claim retrieval process, which takes approximately 8 weeks.
5. Day 30 – 65:  Effective October 1, 2009 the MSPRC will issue a conditional payment letter to the beneficiary and all authorized parties reflecting Medicare’s recovery amount within (65) days of the date of the RAR.
6. An updated conditional payment amount can only be requested every 90 days.
7. Day 66 – 95: Once all settlement information has been provided to the MSPRC, the demand should be issued within 10 – 30 days.

* The estimated turnaround times for Medicare Conditional Payment summaries and Final Demands can vary and may be prolonged due to volume as a result of  the newly implemented reporting requirements under MMSEA Section 111.  Further instruction on the Medicare Secondary Payer process is found on www.msprc.info.

Lien Settlement Solutions can assist in the resolution of Medicare liens.  Contact us at info@lienss.com or by calling us at (877)907-5436 for more information on how we can help.

September 30, 2010

• Posted the September 22, 2010 NGHP Town Hall Teleconference Transcript to the NGHP Transcripts section page.
• Moved the January 28, 2010 NGHP Town Hall Teleconference Transcript to the Mandatory Insurer Reporting section page under NGHP Transcripts.
• Moved the May 26, 2009 Alert: Compliance Guidance Regarding Obtaining Individual HICNs and/or SSNs for Group Health Plan from the What’s New section page to the GHP Alerts section page.
• Moved the August 24, 2009 – HICN, SSN Collection – NGHP Model Language from the What’s New section page to the NGHP section page.
• Moved the August 24, 2009 Alert – Compliance Guidance Regarding Obtaining Individual HICNs and/or SSNs for NGHP Reporting from the What’s New section page to the MMSEA 111 Alerts section page.
• Moved the May 27, 2010  - May 27, 2010  - Updating Language –  ALERT For Liability Insurance (including Self-Insurance), No-Fault Insurance, and Workers’ Compensation RREs – Periodic Workers’ Compensation and No-Fault Payments from the What’s New section page to the MMSEA 111 Alerts section page.

Lien Settlement Solutions can assist your firm with Medicare Compliance and understanding MMSEA Section 111 Reporting Requirements.  Contact us today for more information on how we can benefit your firm!  (877)907-5436 / info@lienss.com.

* By Mail

Group Health Plan (GHP) Inquiries and Checks (e.g. all GHP checks and inquires including Congressional, FOIA, Bankruptcy and QIC/ALJ)

MSPRC – GHP

P.O. Box 138856

Oklahoma City, OK 73113

 

Non-Group Health Plan (NGHP) Inquiries and Checks (e.g. all NGHP checks and inquires including Liability, No-Fault, Workers Compensation, Congressional, FOIA, Bankruptcy, Liquidation Notices and QIC/ALJ)

MSPRC – NGHP

P.O. Box 138832

Oklahoma City, OK 73113

 

Special Projects (e.g. all Product Liability Case Inquiries and Special Project Checks)

MSPRC – Special Projects

P.O. Box 138868

Oklahoma City, OK 73113

* By Fax

MSPRC Correspondence (On your fax coversheet, please identify your correspondence as GHP or NGHP)

             405-869-3309 

Lien Settlement Solutions can assist with the resolution of Medicare liens and Medicare Compliance issues.  Contact us today for more information on how our Medicare experts can benefit your firm! (877)907-5436 phone, info@lienss.com.

http://www.cms.gov/mandatoryinsrep/04_whats_new.asp?

August 2, 2010

• Posted the  Revised – July 30, 2010  NGHP Notice and Agenda For 2010 Teleconferences to the NGHP section page.  This document includes all call in information for these teleconferences.
• Posted MMSEA 111 – July 12, 2010 – Revised – User Guide – Liability Insurance (Including Self-Insurance), No-Fault Insurance and Workers’ Compensation User Guide, Version 3.1 to the NGHP section page.
• Transitioned the 2009 NGHP audio transcripts to the Mandatory Insurer Reporting section page.
• Provided an Opportunity to Comment on Section 111 link on the Overview section page in the Related Links Inside CMS section.
• Transitioned most of the NGHP alerts to the NGHP Alerts section page.