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Message from MSPN President John Kane
Be a Part of Who We Are and What We Do
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When people ask about MSPN, I advise we are a national Medicare Secondary Payer (MSP) network made up of experts in the field. We have come a long way since 2005 when this organization was founded, and we continue to push forward our mission and vision.
We have
expanded our organization beyond MSA’s with the inclusion of Section
111 Reporting and conditional payments and we continue to develop and
diversify our membership and corporate sponsorship. As we know
firsthand, MSP is an ever-changing landscape that impacts workers’
compensation and liability claims; over the years we have worked
together exchanging ideas, evolving our practice, and educating our
organization.
I love this quote from David Weinberger: "The smartest person in the room, is the room!" Our
collective knowledge and resources will improve compliance, preserve
the Medicare fund, and assist the injured worker’s experience before and
after the settlement. What a great cause and organization.
MSPN
has fostered a very good working relationship with CMS holding periodic
meetings to raise any trends, opportunities or new policy clarification
brought forth by our committees, members, or board.
This
year, we ask that you consider joining one of the many great
committees, Membership, Education, Communication, Policy and more. Be involved and sign up now!
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Our Mission
To serve as the leading advocate for an efficient and effective MSP compliance system and as the industry resource for all involved parties.
Our Vision
Drive action through educational programs and resources, legislative
advocacy, and a focus on sharing information amongst all to improve and
lift the industry.
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Before we fully move into 2023, I wanted to recognize some of the milestones we saw in 2022.
Lookback in 2022:
- There were 3 major releases of the WCMSA Reference Guide:
- January 10, 2022, Release, Version 3.5. Section 4.3, The use of non-CMS approved products.
- March 15, 2022, Release Version 3.6, Clarification following CMS Town Hall
- November 14, 2022, Release Version 3.8.Section 16.1 Re-Review
- Private Cause of Action – double damages.
- Repair Abuses of MSP Payments (RAMP Act – H.R. 8063)
- Trending in the courts. Case Law Update
- Section 111 Reporting – CMS shared Top 10 error codes per request from MSPN.
- LMSA’s – CMS withdrew the proposed rule on 10/13/22. Will monitor for future rulemaking.
- CMS Released Key Metrics on WCMSA Review Program. CMS shared statistics over a three-year period from 2020 through 2022. The data compared proposed MSA amounts with the CMS-recommended amounts.
Looking ahead in 2023 and Beyond:
- WCRC Contract:
- CMS released the solicitation on 1/4/2023 with a contract start date of 4/4/23.
- WCRC to continue to review all CMS Review Threshold MSA’s with the ability to complete LMSA reviews starting in 2024 with an expectation of 1,000 per year.
- We will be monitoring this contract closely for any changes in contractor.
- Section 111
- Civil Monetary Penalties – Final rule extended for another year, 2/18/24.
- CMS released User Guide 7.0 on 1/9/23, As of July 2023, RREs will be informed when another party updated the records. RREs can receive a monthly Unsolicited Response File providing key information about updates to ORM records and will be allowed to either update the internal data or contact the BCRC for a correction.
As a member of MARC, we’ve provided advocacy and collaboration, regulations, policy memoranda, and reference guides.
- Medicare Advocacy and Recovery Coalition (MARC) is led by David Farber with Spaulding and King. MARC is an advocate for improvement of MSP programs seeking legislative and regulatory reform efforts. MSPN became a member of MARC back in 2021 as our voice on Capital Hill. MSPN is an ally and corporate sponsor of MARC.Ciara Koba is our MSPN representative on the MARC Board of Directors. MARC Initiatives:
- Repair Abuses of MSP Payments (RAMP Act – H.R. 8063). Bill will need to be re-introduced.
- RAMP would repeal the MSP “Private Cause of Action” provision.
- Advocacy on Treasury collection activities.Better guidance on how Treasury handles debts.
- Advocacy on ORM Termination, list of Top 10 issues by RRE’s.
This year we’ve focused on five key strategic objectives for our organization:
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Expand and diversify our member and corporate sponsorship. Identify plaintiff, structure broker and other national associations to add to the organization.
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Enhance the organization visibility with other organizations and events.
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Identify relevant MSP trends to ensure we are addressing topics in a timely manner.
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On a quarterly basis, meet with CMS management on escalated issues from our member base to seek mutual solutions.
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Seek additional MSP baseline metrics with CMS that translate into opportunities to develop policy positions for recommended MSP reforms.
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I look forward to the year(s) ahead expanding our membership base, creating further MSP transparency and reform efforts. I especially want to thank you, our members, corporate sponsors, CMS officials, committee and board members for your continued engagement and support.
Save the date for another great MSPN Conference in Baltimore!
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620 Florida Street, Suite 210, Baton Rouge, LA 70801
Phone: (225) 454-6164
Website: www.mspnetwork.org
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