CMS releases updated (MSPRP) User Guide (Version 5.6)

January 17, 2023 / 6 min read

The Centers for Medicare and Medicaid Services (CMS) has released an updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide Version 5.6 (January 9, 2023). CMS’s updates in Version 5.6 specifically relate to the use of the Open Debt Report functionality, the compromise request submission process, and the Go Paperless functionality^.[1]

The below provides a general overview of these updates as follows:

Open Debt Report updates

As part of this update, CMS indicates that Section 111 reporting recovery agents will now have access to the Open Debt Report for their Responsible Reporting Entity’s (RRE) recovery cases. Specifically, CMS notes that recovery cases will appear on a recovery agent’s Open Debt Report when the recovery agent tax identification number (TIN) submitted to CMS via the RRE’s Section 111 reporting matches the recovery agent’s TIN.^[2]

Additionally, CMS has also added two new search fields to the Open Debt Report page, allowing users to search by RRE ID and Insurer TIN. When combined with the ability to narrow search results by the date a conditional payment demand was issued, this feature should allow MSPRP Account Managers to generate more customized Open Debt Reports.

Compromise request updates

The second update made by CMS pertains to the compromise request submission process, which allows Medicare beneficiaries and users with a verified Beneficiary Proof of Representation (POR) to submit requests that Medicare compromise the amount owed on a Benefits Coordination & Recovery Center (BCRC) beneficiary-debtor conditional payment case and accept a reduced amount via the MSPRP.^[3] As part of the Version 5.6 update, CMS indicates that the “Submit Compromise Request” button will not be available in the MSPRP if there is still a decision pending on a previous compromise request. Additionally, users will only be able to submit a compromise request if the estimated demand amount (which is automatically calculated by Medicare based on the conditional payment amount minus Medicare’s share of procurement costs) is greater than the compromise amount.^[4] Another update to the compromise request process is the renaming of the “Additional Notes” text box to “Reason for Compromise” and the addition of the “Attorney Fax Number” field on the Compromise Request page in the MSPRP. The “Reason for Compromise” box can be used by submitters to state the reason why they believe CMS should grant a compromise.

Go Paperless functionality updates

The final area addressed by the Version 5.6 updates surrounds enhancements to the Go Paperless functionality. CMS indicates the MSPRP has been updated so that users can now view the RRE ID and RRE name on the “Letters for E-mail Date” page in the MSPRP as well as in the daily letter notification e-mails. Additionally, when a user downloads correspondence via the paperless functionality the last five characters of the filename will now include the RRE ID associated with that letter. Finally, users are also now able to see when paperless letters were downloaded on the “Letters for E-mail Date” page in the MSPRP. These added functionalities may make it easier for MSPRP users to identify and track the correspondence sent to them as part of their Go Paperless notifications.

Questions?

Please do not hesitate to contact the author if you have any questions or would like further information on how Verisk can help you address your conditional payment claims.

How Verisk can help!

Keep in mind that Verisk has proven services to help you address CMS conditional payments, Treasury claims, as well as Medicare Advantage and Part D claim. For example, CP Link^® is our programmatic solution that automates CMS conditional payment identification, dispute, and resolution directly from Section 111 data for holistic compliance. With our new CP Link^® PAID Act add-on component, insurers can now also use CP Link for a programmatic approach to Medicare Advantage (MAP) and prescription drug (Part D) recovery claims. We also offer our standard Medicare conditional payment, Medicare Advantage Resolution service and Treasury Claims services.

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[1] As part of this update, CMS includes a “Summary of Version 5.6 updates” which states, in full, as follows:

The following updates have been made in Version 5.6 of the Medicare Secondary Payer Recovery Portal (MSPRP) User Guide:

To allow Section 111-reported recovery agents access to the Open Debt Report for their RRE’s cases, the following changes have been made (Section 14.1):

The Welcome page now shows the Open Debt Report link and related text when the user is the AM of an MSPRP account that has been identified as a recovery agent.
The Open Debt Report page has two new search fields (RRE ID and Insurer TIN).
The Export to Excel button has been changed to Export All Results.
Cases will appear on the recovery agent’s Open Debt Report when the recovery agent TIN submitted for a case matches the recovery agent’s TIN.

To improve the compromise request submission process, the MSPRP has been updated as follows (Sections 15.1.2.13, 17.3.1, and 17.3.2):

The Submit Compromise Request button will not be shown on the Case Information page if a decision on a previous compromise request associated with the case is still pending.
The Additional Notes text box has been changed to Reason for Compromise and a new Attorney Fax Number field has been added to the Compromise Request page.
The Continue button on the pre-demand Compromise Request page will only be visible if the estimated demand amount is greater than the compromise amount. Note: The estimated demand amount does not appear on the Compromise Request page; it is automatically calculated by the MSPRP based on the overpayment amount minus Medicare’s share of procurement costs.

To enhance Go Paperless functionality, the MSPRP has been updated so users can view the RRE ID and name on the Letters for E-mail Date page and letter notification emails and see when paperless letters were downloaded (Sections 14.2 and 15.1.1.4):

A Clear button and two new columns (Downloaded and RRE ID/Name) have been added to the Letters for E-mail Date
The last five characters of the filename now include the RRE ID associated with the image for letters on the Letters for E-mail Date and Images for Correspondence Type

To ensure users can view the same case information on the Case Listing page as the open debt report, a note has been added to remind users to request case access to see the information on both pages (Section 14.1). See, Medicare Secondary Payer Recovery Portal (MSPRP) User Guide, (Version 5.6, January 9, 2023), Chapter 1, Summary of Version 5.6 Updates.

[2] Medicare Secondary Payer Recovery Portal (MSPRP) User Guide, (Version 5.6, January 9, 2023), Chapter 1.

[3] Medicare Secondary Payer Recovery Portal (MSPRP) User Guide, (Version 5.6, January 9, 2023), Chapter 15.1.2.13.

[4] Medicare Secondary Payer Recovery Portal (MSPRP) User Guide, (Version 5.6, January 9, 2023), Chapter 1.