Winds of Change Blowing at the MSPRC?

Posted date in Jason D. Lazarus, J.D., LL.M., MSCC Medicare Secondary Payer Act

With the recent AAJ announcement and rumblings within the Medicare compliance community, it appears the winds of change are blowing.  It is being reported that when the Chickasaw Nation Industries’ contract to manage the MSPRC expires on 9/30/2011 it will not be renewed.  From what I have heard, the MSPRC will be handled on an interim basis by Group Health Incorporated (GHI) who has been the contractor handling the COBC’s work since 1999. 

While one source is reporting that the government is seeking proposals for a new provider for the MSPRC, the link that is provided is for a new “Medicare Secondary Payer Integration Contractor (MSPIC)”.  It appears from the web link that this request for proposals has to do with IT systems integration for the MSP programs.  It does not appear that this is a RFP for MSP recovery contractors. 

That being said, it does appear that the MSP recovery contractor is in the process of being replaced.  As has been pointed out by other commentators, the Chickasaw Nation was blasted for poor performance by the US Senate Subcommittee on Contracting Oversight as a result of a 2009 investigation.  In a memo regarding the current Medicare Secondary Payer Recovery Contractor, Senator Claire McCaskill (Chairman of the Subcommittee on Contracting Oversight) stated there were “ongoing performance problems on the MSPRC contract”.  The memo identified “significant deficiencies”; “failure to respond to communications in a timely manner” and a “lack of internal controls”.

Everyone that has dealt with the MSPRC knows they are inefficient.  The hold times when calling in are ridiculous.  Response times to requests for CPLs and final demands are unacceptable. The only thing worse than all of this is the on hold music one has to endure while waiting to speak with someone at the MSPRC.  The SMART Act would rectify some of the current issues that plague the Medicare recovery system and perhaps a change of the MSP recovery contractor would be helpful as well.  Only time will tell.