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John Bair
John Bair
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CMS Issues Interim Final Rule on Expansion of MSP Portal

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This morning, the Centers for Medicare and Medicaid Services released an interim final rule with direct impact on SMART Act regulations.

The interim final rule explains the process and timeline for taking Medicare’s Secondary Payer web portal and expanding it to conform to regulations set forth in the SMART Act.  The portal is intended to provide beneficiaries, authorized family members/representatives, or applicable plans (with consent from the beneficiary) with access to the beneficiary’s Medicare Secondary Payer information.

The newly updated portal will have a multifactor authentication security feature that will allow an authorized representative or applicable plan certain privileges not available under the current system.

To more easily understand the newly updated MSP process, CMS provided this diagram:

CMS Diagram

 

 

Why is this update important?

The ability to get the conditional reimbursement amount in a more streamlined, time-bound manner will make the process run much more smoothly for Medicare beneficiaries involved in personal injury or Workers’ Compensation settlements.

The newly expanded portal will permit users to:

  • Notify CMS that a case is nearing settlement
  • Obtain time and date stamped final conditional payment summary forms and amounts prior to settlement
  • Ensure that disputes/discrepancies are addressed within 11 business days of receipt of said dispute documentation

 

CMS expects to fully implement portal updates no later than January 1, 2016.

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