Industry News & Tips


May 07, 2011

Gene Horton


Because of the high cost of buying USL&H insurance it is understandable that many businesses without any employees but themselves look for ways to avoid having to buy the coverage. One very troublesome misconception is that if the worker/contractor is sixty-five years of older he/she doesn’t need to buy the insurance. I have had several customers tell me “they don’t need the coverage because they are on Medicare. This could be a very harmful misconception. If you are injured on the job and are treated under your Medicare insurance, Medicare can and will recover any money paid on your claim. Medicare does this under “Medicare Secondary Payer Recovery”.  This means that if an injury was occupational related and should be covered under a workers compensation policy, Medicare will take steps to recover any monies they paid on your behalf. To get all the details please visit their websites at

. Of particular help is their “Tool Kit”. Also very helpful is their “Attorney Tool Kit”. In it they have a flow chart. You will need an attorney if you don’t have insurance! As many of you have been told by me, there are no good deals in this insurance. Often, even the broker is forced to take a very minimal commission so everyone is a looser in game. If you have any questions please e-mail me and I will try to help you with some solutions.


Thanks for your support,

Gene Horton



The first step in the Medicare Secondary Payer recovery process is reporting your case to the Coordination of Benefits Contractor (COBC).  If you have not reported your case, please


for COBC reporting instructions and contact information.

Don’t Forget!


Once you establish your case with the COBC, you will receive a "Rights and Responsibilities" (RAR) letter from the MSPRC.  The MSPRC will then automatically generate a "Conditional Payment Letter" (CPL) within 65 days from the date on your RAR letter.  You do NOT need to request the CPL separately.

Alert: MSPRC Mailing Addresses and Fax Number Have Changed!

As of September 30, 2010, all MSPRC mailing addresses and the MSPRC fax number have changed. The new addresses and fax number have been updated on, our call center system, and on all outgoing written correspondence. Please share this information with all appropriate staff.

For an immediate e-mail notification when this change occurs, through our E-mail Newsletter,


To view the new addresses and fax number, visit our



Top of Form

Letter ID Quick Search

Bottom of Form

News and Updates

ALERT UPDATE: Issuance of the Demand letters is temporarily suspended - Review of the Rights and Responsibilities letter is complete

The Demand letter for liability insurance (including self-insurance), no-fault insurance and workers’ compensation has been temporarily suspended while this letter is under review. The MSPRC is still working cases, and Demand letters will be mailed out once this review is complete. Review of the Rights and Responsibilities letter (“RAR”) is complete. Issuance of the RAR is anticipated to resume on June 10, 2011. A copy of the revised RAR will be made available by that time on this website.


The Medicare Secondary Payer Recovery Contractor (MSPRC) protects the Medicare trust fund by recovering payments Medicare made when another entity had primary payment responsibility.  The MSPRC accomplishes these goals under the authority of the Medicare Secondary Payer (MSP) Act.  The MSPRC identifies and recovers Medicare payments that should have been paid by another entity as the primary payer either under a Group Health Plan (GHP) or as part of a Non-Group Health Plan (NGHP) claim which includes, but is not limited to 

Liability Insurance (including Self-Insurance), No-Fault Insurance, and Workers' Compensation.  The MSPRC does not pursue supplier, physician, or other provider recovery.

Please utilize the tools and resources available on this site for more information on the recovery process.