Verisk Analytics : CMS Holds Webinar to Address Plans to Add Electronic Payment Functionality to its Medicare Secondary Payer Recovery Portal

On March 13, 2019, the Centers for Medicare and Medicaid Services (CMS) held a webinar to discuss its plans to add electronic payment functionality to its Medicare Secondary Payer Recovery Portal (MSPRP). The MSPRP relates to non-group health (NGHP) claims which include workers' compensation, liability and no-fault.

Key highlights addressed by CMS on this webinar regarding the MSPRP's expanded functionality included:

General Features

• As of Monday, April 1, 2019, MSPRP users will be able to submit payments for demands via the portal and track that payment is accurately applied.
• Only a recovery case in demand status will be eligible for electronic payment via the MSPRP. Thus, a Conditional Payment Letter (CPL) or Conditional Payment Notice (CPN) will not be eligible for this electronic payment process.
• No additional user access or authorization will be needed to submit payments electronically.
• There is no restriction or exclusion regarding who can submit payments electronically. On this point, CMS indicated that beneficiaries, attorneys, and primary payers can all utilize this new process for payment.
• If the demand balance amount is zero, electronic payment will not be accepted.
• If electronic payment is made on the due date, CMS will consider this timely payment.
• The MSPRP will allow the user to view payment status and history.
• Payment processing time is 1-3 days on average and the statement will reflect that payment was made to 'HHSCMS.'
• Partial payments will be accepted, and it will be assumed that when this occurs the remaining charges are contested. An appeal can be conducted concurrently with the electronic partial payment.
• While the portal will now be able to accept payments, CMS advised that parties may still submit payment via mail if they prefer as this new electronic process will not replace any existing payment processes.

Functionality Features

• When a user opts for electronic payment, they will be taken from the MSPRP to a separate website managed by the federal government, pay.gov, where payment is processed. Once the pay.gov transaction is completed, the user will be returned to the MSPRP.
• CMS said pay.gov is a secure, online payment system overseen by the U.S. Department of Treasury and it works with the MSPRP.
• Pay.gov does not charge a fee and allows for the following payment methods:
  • Direct payment from checking or savings - a user will need the account holder's name, account number, and routing number.
  • Debit card - note that debit cards will be declined if the maximum amount of the debt exceeds $24,999.99.
  • Credit card.
  • PayPal (payments will be limited to $10,000.00).
  • If there are issues with pay.gov, a user can contact customer support at 800-624-1373. If there are issues with the MSPRP, a user can contact 646-458-6740.

Going forward, claims payer using the MSPRP will need to determine if they would like to use this new option, assess their ability to do so, and develop any applicable internal protocols.

If you have any questions, please contact Shawn Deane at [e-mail] or 978-825-8158.

Shawn Deane is vice president of Medicare / Medicaid compliance and policy at ISO Claims Partners where he concentrates on all facets of Medicare Secondary Payer (MSP) compliance. Before joining ISO Claims Partners, he practiced healthcare law and insurance defense. Shawn is on the executive committee as treasurer of the Medicare Advocacy Recovery Coalition (MARC) and was the 2017 president of the National Alliance of Medicare Set-Aside Professionals (NAMSAP). He has attained the Medicare Set-Aside Certified Consultant (MSCC), as well as the Certified Medicare Secondary Payer Professional (CMSP) certifications. Shawn is a member of the Massachusetts Bar and is licensed in both state and federal courts in Massachusetts.