CMS to Combine MSPRC and COBC; Appoints Interim MSPRC Contractor

The Centers for Medicare and Medicaid Services (CMS) will combine its Medicare Secondary Payer Recovery Contractor (MSPRC) and Coordination of Benefits Contractor (COBC) contracts into a centralized contract, called the “Medicare Secondary Payer Integration Contractor (MSPIC)”. CMS hopes that by merging these activities, they can provide a single point of contact, improve data and debt collection, and enhance customer service.

The current MSPRC contract, awarded in 2006 to Chickasaw Nation Industries, Inc. a tribally owned, Oklahoma based firm, expires on September 30, 2011 and will not be renewed.

Beginning October 1, 2011, the MSPRC work will be performed by Group Health Incorporated (GHI) until the new MSPIC contract is awarded.  Group Health Incorporated has been CMS’ COBC contractor since 1999.

The new MSPIC contract “sources sought notice” was posted on the website August 24, 2011. CMS anticipates that the MSPIC contract will be awarded in late spring/early summer of 2012.

Chickasaw Nation Industries’ performance came under fire recently by the U.S. Senate Subcommittee on Contracting Oversight, sighting “ongoing performance problems”, “significant deficiencies” and “failure to respond to communications in a timely manner”.  The MARC Coalition, formed in 2008, has been a strong advocate to reform the Medicare Secondary Payer recovery process and was the driving force behind the introduction of the SMART Act of 2011 by the U.S. Congress.  Also, recent congressional hearings by the Oversight and Investigations Subcommittee pointed out serious problems with the entire recovery process.  CMS seems to be responding to these complaints with strong positive changes.  In 2011, CMS awarded a new WCRC contract to Provider Resources, Inc., implemented a $300 threshold for liability settlements, and now it has made a major change in its MSPRC contract.

View the Sources Sought Notice at here.
View the Senate Subcommittee on Contracting Oversight fact sheet here.
View the MARC Coalition website here.
View the Medivest blog on the SMART Act of 2011 here.
View the Medivest blog on the US Congressional Oversight and Investigations Subcommittee hearings here.