CMS Releases Updated MSPRP User Guide (Version 6.5)

April 23, 2025 / 3 min read

The Centers for Medicare and Medicaid Services (CMS) has released an updated Medicare Secondary Payer Recovery Portal (MSPRP) User Guide Version 6.5 (April 7, 2025) which includes several updates to MSPRP functionality, including changes to the case creation process, changes to the registration and login process, and changes to the compromise process.^[1]

The below provides a general summary of the updates contained in version 6.5 of the MSPRP User Guide:

Updates to Case Reporting

Version 6.5 indicates that MSPRP users will no longer be able to report a case via the MSPRP if the beneficiary was not entitled to Medicare on the date of incident.^[2] Section 13.1.2 of the User Guide has been updated to reflect that the date of incident field must be a date on or after 1/1/1990, in MMDDYY format, within the beneficiary’s current and/or previous Medicare Part A or Part B entitlement period, and prior to the current date.^[3]

Attorneys’ Fees and Expenses on Workers’ Compensation Cases

CMS notes in the summary of updates that users will now be able to include attorneys’ fees and/or expenses when reporting settlement information for workers’ compensation cases where the beneficiary is the debtor.^[4]This change will allow parties submitting settlement information for workers’ compensation claims to use the MSPRP to provide CMS with the information necessary to reduce CMS’s recovery amount to account for the beneficiary’s procurement expenses, as outlined in 42 CFR § 411.37.^[5]

Changes to Registration and Login Process

CMS has indicated that the security question selections for the initial registration and password reset procedure have been changed.^[6]CMS has updated the questions an MSPRP user will be asked when a user indicates they have forgotten their Login ID or Password to “What is the name of your childhood best friend” and “What is your maternal grandmother’s first name.”^[7]

Updated Fax Number

As part of the updates to version 6.5, CMS states that the fax number for the Medicare Benefits Coordination & Recovery Center (BCRC) has changed.^[8]The updated fax number in Figure 13-2 is (833) 844-1540 and the User Guide indicates this fax number can be used for cases related to exposure to an environmental hazard or ingestion of a particular substance, or an issue with an implanted medical device.^[9]These cases are handled by the BCRC’s Special Projects division and the User Guide notes these cases should not be reported via the MSPRP.^[10] Additional contact information can be found on CMS’ website.

Changes to Compromise Process

CMS’s final stated update to Version 6.5 is a clarification of changes to the compromise process, whereby the ability to submit a pre-settlement compromise has been removed from the MSPRP.^[11] Compromise requests allow beneficiaries and users with verified Beneficiary Proof of Representation (POR) authorizations to submit requests that Medicare compromise the amount owed on a debt and accept a lesser amount.^[12]The User Guide indicates that compromise requests can be made after the case settles and the funds have been paid.^[13]In order to request a compromise, the MSPRP case must be in Bill Issued, Demand, or Demand in Progress status, and such requests cannot be submitted when the case status reflects Claim Retrieval, Closed, In Development, or Transitioned.^[14]

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.

[1] The full list of updates in Version 6.5 of the MSPRP User Guide, as stated by CMS in the “Summary of Version 6.5 Updates”, is as follows: “The following updates have been made in Version 6.5 of the Medicare Secondary Payer Recovery Portal (MSPRP) User Guide: To stop inaccurate case creation, users will not be able to report a case if the beneficiary was not entitled to Medicare as of the date of incident (Section 13.1.2). The ability to include attorney fees and/or expenses has been added for workers’ compensation (WC) cases where the debtor is the beneficiary (Section 15.1.2.9). To reflect changes to the registration and login process, the security question selections for initial registration and password reset procedure have changed (Section 6.4). The fax number for the Benefits Coordination & Recovery Center (BCRC) has changed (Section 13.1.1). To clarify changes to the compromise process, the ability to submit a pre-settlement compromise has been removed from the MSPRP (Sections 15.1.2.13, 17.3.2).”

[2] Medicare Secondary Payer Recovery Portal (MSPRP) User Guide Version 6.5 (April 7, 2025), Chapter 1.

[3] Id, Chapter 13.1.2.

[4] Id, Chapter 1.

[5] 42 CFR § 411.37(a), which states: “(a) Recovery against the party that received payment—(1) General rule. Medicare reduces its recovery to take account of the cost of procuring the judgment or settlement, as provided in this section, if— (i) Procurement costs are incurred because the claim is disputed; and (ii) Those costs are borne by the party against which CMS seeks to recover.”

[6] Medicare Secondary Payer Recovery Portal (MSPRP) User Guide Version 6.5 (April 7, 2025), Chapter 1.

[7] Id, Figure 6-16.

[8] Id, Chapter 1.

[9] Id, Figure 13-2.

[10] Id.

[11] Id, Chapter 1.

[12] Id, Chapter 15.1.2.13.

[13] Id.

[14] Id.