New Process for Obtaining Final Demand PRIOR to Settlement Coming Soon!

On Monday, November 9th, CMS issued an alert regarding the ability to obtain a Final Conditional Payment Amount prior to settlement finalization which states:

"As part of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act), the MSPRP will be modified to include Final CP process functionality by January 1, 2016. This new functionality will permit authorized MSPRP users to notify CMS that a recovery case is 120 days (or less) from an anticipated settlement and request that the recovery case be a part of the Final CP process.

When the Final CP process is requested, any disputes submitted through the MSPRP will be resolved within 11 business days of receipt of the dispute. Once all disputes have been resolved, and the case is within 3 days of settling, the beneficiary or their authorized representative will be able to request a Final Conditional Payment Amount on the MSPRP. Once calculated, this amount will remain the Final Conditional Payment Amount as long as:

1. The case is settled within 3 calendar days of requesting the Final Conditional Payment Amount, and

2. Settlement information is submitted through the MSPRP within 30 calendar days of requesting the Final Conditional Payment Amount."

In effect, parties will have the ability to obtain the final lien amount prior to the conclusion of the settlement process; something we believe will allow parties to comprehensively address lien repayment in the final settlement agreement. We will keep you posted as this process is further discussed.

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