CMS Publishes New Version of MMSEA Section 111 Medicare Secondary Payer Mandatory Insurer Reporting User Guide, Version 4.1
Jesse Hamby
February 19, 2014

CMS released their latest User Guide to update two important recent developments.

First and foremost, to harmonize the document to reference the correct Medicare recovery contractor.  The BCRC (Benefits Coordination & Recovery Center) is officially open for business, and with it comes the retirement of the Coordination of Benefits Contractor (COBC) and the Medicare Secondary Payer Recovery Contractor (MSPRC).   This is simply a re-branding change, not a substantive one.  From operations standpoint, no appreciable changes will be felt.

When dealing with the BCRC, realize that it is part of a larger contract awarded by CMS that created the Coordination of Benefits & Recovery (COB&R).  As such, you may see this acronym included as part of the re-branding efforts.  Also important to note is that the website:  www.msprc.info will be retired as of 4/1/2014.  Information previously obtained from this website can be found at http://go.cms.gov/cobro.

The second change made with the introduction of the new user guide relates to the use of certain diagnosis codes that are unrelated to the incident from applying to no-fault records found in the Common Working File, the database used by the BCRC.  These codes when used in conjunction with a No-Fault file (Plan Insurance Type D in field 51) may result in denial of treatment by Medicare.  Click here for the following codes which are now invalid for purpose of this insurance type.

We will continue to analyze the new user guide for any information that could impact reporting of data to CMS.  Please continue to visit our website for important updates.

Chapter I – Introduction and Overview

Chapter II – Registration Procedures

Chapter III – Policy Guidance

Chapter IV – Technical Information

Chapter V – Appendices