Medicare’s Agents: CMS, BCRC, and CRC
For Medicare Liens, the agency is represented by one branch of the government and two contractors. Those actors are:
- CMS – the Centers for Medicare and Medicaid Services. CMS is the government agency involved in Medicare Liens and works beneath Health and Human Services of the Executive Branch;
- BCRC – the Benefit Coordination & Recovery Center. The BCRC handles recoveries from those receiving funds (plaintiffs). That receipt of funds includes voluntary payments from carriers, settlements, judgments, and more.
- CRC – the Commercial Repayment Center. The CRC handles recoveries from those with “Ongoing Responsibility for Medicals,” or ORM. In turn, ORM means any continuing payments like PIP, Med-Pay, etc. that are not being paid directly to a plaintiff. Medicare learns about such responsibility from its Mandatory Insurer Reporting process.
The timing of when each file can be opened creates a wrinkle in this process. The BCRC has difficulty opening No-Fault files where the CRC already has one open (usually the BCRC file opens and immediately closes through an automated process). We’ve found that the best solution is to monitor the CRC file until a No-Fault settlement, then, notify BCRC. The settlement information will prevent this automated closing process.
Which file do you need right now? Here’s a few options:
Defense Payment Type | Medicare File Type | Who is Responsible? |
PIP/Med-Pay (Voluntary Pay) | CRC – No-Fault | Carrier |
PIP/Med-Pay (via Settlement/Judgment) | BCRC – No-Fault | Plaintiff |
Work Comp (Voluntary Pay) | CRC – Work Comp | Carrier |
Work Comp (via Settlement/Judgment) | BCRC – Work Comp | Plaintiff |
Liability or Bodily Injury (via Settlement/Judgment) | BCRC – Liability | Plaintiff |
Underinsured Motorist Coverage (via Settlement/Judgment) | BCRC – Liability | Plaintiff |
Uninsured Motorist Coverage (via Settlement/Judgment) | BCRC – Liability | Plaintiff |
Additional Defendant in Liability (via Settlement/Judgment) | BCRC – Liability | Plaintiff |
MASSIVE will be at the Michigan Association for Justice’s (MAJ) 2022 Winter Convention on Friday, January 14 in Novi, Michigan. Visit our booth and find out why MASSIVE is Michigan’s Medicare Lien experts!