Workers' Comp

New Workers' Compensation Review Contractor

March 9, 2018
2 MIN READ

Keep current with new legislation and its potential effect on your organization. This regulatory update is for informational purposes only, and provides some key highlights on state initiatives that may impact the Medicare Set-Aside services Genex provides.

On Wednesday March 7, 2018, CMS hosted a webinar to introduce Capitol Bridge, LLC as the new contractor that will be taking over the review of MSA proposals effective March 19, 2018.  The Capitol Bridge team has over 25 years of CMS support experience and the review team is comprised of pharmacists, and Medicare Set-aside Consultant Certified nurses and attorneys.

Provider Resources Inc. (PRI), the current WCRC contractor will cease production effective the close of business Friday March16, 2018. Capitol Bridge will begin reviewing WCMSA proposals and recommending WCMSA amounts to CMS for final determination on Monday March 19, 2018. Any MSA proposals that are presently under review or that have been developed will be transferred to Capitol Bridge. Any correspondence that is mailed or faxed to PRI post transition will automatically be forwarded to Capitol Bridge for a certain period of time after the transition. PRI will be working up until the very last day and Capitol Bridge does not anticipate any backlog because of the transition

What is Remaining the Same?

  • The review and decision-making process
  • All established timeframes (20 business days from receipt of all documents to complete the review)
  • WCMSA proposals will continue to be submitted through the portal or by mail to the same Oklahoma City address

What is Changing?

  • All case processing will occur out of Capitol Bridge’s Pittsford, NY facility.
  • The preferred contact method is via the customer service phone number: (833) 295-3773
  • The fax number is (585) 425-5390
  • The email address: WCRC@capitolbridgellc.com

Information containing PHI should not be faxed and all MSA submissions should continue to be sent via regular mail or via the web portal.

Inquiries will not be addressed without a specific case number.

Capitol Bridge answered numerous questions after the presentation. They did not address Liability and No Fault MSAs which per the bid proposal they have the potential to begin reviewing as early as July 1, 2018. Capitol Bridge stated that they answered all questions that they felt appropriate for the venue.

For more information/questions about the WCRC Contractor Transition or the status of your MSA submission please contact Genex MSA  1.888.GO.GENEX or msadirect@genexservices.com.