There’s some irony about the fact that Medicare Secondary Payer (MSP) greatly affects the beneficiary, yet they – and oftentimes their representative – have the least amount of participation or knowledge in the various compliance activities. For example, a Medicare Set Aside (MSA) has a profound impact on the beneficiary. After all, it’s a document and fund of money that’s available to them for their lifetime to ensure Medicare is available. However, most of the time they don’t know anything about it until well after the settlement. Even then, they are often confused about how to properly administer it.
When a beneficiary resolves a claim and receives a recovery letter for Medicare conditional payments – they often have no one to turn to for help. If a Medicare beneficiary receives a denial for treatment for services unrelated to their work-injury, they typically don’t know how to rectify the situation.
Over the last year, stakeholders have alerted the Centers for Medicare & Medicaid Services (CMS) to the need for more education and outreach for beneficiaries and their representatives. To their credit, the agency recently held a webinar covering an introduction to Medicare Secondary Payer (MSP). It was geared towards attorneys who represent beneficiaries and mostly covered fundamentals of MSP and recovery concepts. This coincides with efforts to education this stakeholder group, including issuing the NGHP MSP Beneficiary Reference Guide.
The webinar was broken into several components, including:
- Defining terms and providing background
- MSP and Coordination of Benefits
- Recovery Basics
- The Recovery Process
- The Medicare Secondary Payer Recovery Portal (MSPRP)
- Resources and Links
- Q&A session
The content provided a great foundation for beneficiary representatives who need the “fundamentals” on MSP and this is a wonderful start in the agency’s outreach efforts to the beneficiary representative stakeholder community.
Education can be a wonderful way to show compassion towards a population, as in this case, who is often lost in the complexities of MSP compliance. While J29 mostly serves insurance carriers, self-insureds and TPAs, we’re happy to interface with beneficiaries and their representatives in providing education to help improve claims outcomes and ensure the Medicare trust is protected.
If you participated in the webinar but have additional questions, J29 is happy to help. Please don’t hesitate to contact us. You can reach out to Shawn Deane, who heads-up J29’s MSP compliance program at: Shawn.Deane@j29inc.com.
