Frequently Asked Questions
What is MRN?
The Medicaid Recovery Network (MRN) is a program designed to match insurance claims with Rhode Island Medicaid medical claims. The web-based system matches with insurance claims for personal injury and workers’ compensation on a daily basis. The MRN staff performs quality assurance activities to verify and qualify matches. As a result, the Rhode Island Executive Office of Health and Human Services may send a lien document to the insurer.
What information is included with the Rhode Island Medicaid lien document?
The Rhode Island Medicaid Lien document includes identifying information regarding the Medicaid recipient, a MRN reference number to be used for requesting updated information and notices, and a list of the medical claim payments the Rhode Island Executive Office of Health and Human Services has identified as eligible for lien. Contact information for assistance with the lien document is also available.
Insurers may receive either a lien document or a notice of recipient document.
- The lien document lists medical claims
- The notice of recipient document indicates that RI does not have any medical claims related to the insurance claim at this time
- Both notices are valid for 30 days from the date of issuance
- Insurers must request an updated lien document if settling the case after 30 days of the initial date of issuance
How does the appeals process work?
If disagreement exists regarding medical claims payments referenced on the lien document, please contact MRN Customer Service at #mais_contact_phone#.
How do I join?
Insurers can participate in the RI MRN program by authorizing Insurance Services Office (ISO) to make their claims available through ClaimSearch. For more information please contact your ISO representative or call 1-800-888-4476.
RI MRN has also developed a secure online “Lookup” option, which enables insurers to participate using the MRN interactive online lookup system.
A third option is for insurance companies to establish a direct data match process with MRN. For more information regarding this method, please call #mais_contact_phone#.
How do I register for the online “Lookup” option?
Insurers can register via the Internet by clicking the “Lookup” navigation link located on the left side of this webpage. Companies must complete all the information requested on the registration page. Companies must also agree to the terms of the confidentiality statement.
Once the company information is reviewed and the signed confidentiality statement has been received, secure access to the MRN database will be approved. The company will then be notified via e-mail. This notice will include the User ID that has been assigned, the website address, and basic instructions.
What is the cost?
There is no cost for insurers to participate with MRN, regardless of the method.
How do I request an updated lien document?
Insurers can request an updated lien document by clicking the “Update a Lien” button on the left hand side of the website and entering the MRN ID listed on the lien or notice of recipient document. Insurers are required to provide their e-mail address. Insurers may also request an updated lien by e-mailing us at #mais_contact_email# or calling #mais_contact_phone#. Please be sure to include your e-mail address and the MRN ID number found on your notice.
Who should participate?
All insurers who conduct business in the State of Rhode Island are required to participate in MRN. Please view the Laws page in order to learn about Article 11, relating to Rhode Island’s Medical Assistance Intercept law.
What happens next?
When insurers authorize matching through ISO, they will be contacted by MRN in order to discuss quality assurance methods. After MRN performs quality assurance activities, matches are sent to the Rhode Island Executive Office of Health and Human Services for further follow up. A lien document may be sent to the insurer with additional information and instructions.
Where should I send the payment?
Payments may be addressed to RI Executive Office of Health and Human Services and sent to:
RI Executive Office of Health and Human Services
Third Party Liability Unit Virks Building 3rd Floor
3 West Road
Cranston, RI 02920
Does this apply to self-insured?
Yes, as with the Child Support Lien Network (CSLN), any insurer doing business in Rhode Island shall be subject to this intercept law.
What is expected of the carrier if the lien is greater than the settlement amount as a result of an assessment of comparative negligence? Wouldn't the amount recoverable on the lien be subject to the same offset?
Medicaid can recover up to the amount expended for medical assistance from an insurance payment made by an insurer relating to the injury. Comparative negligence is not a factor. Furthermore, recovery is limited to the extent of the coverage.
Is an MRN lien applicable to first party benefits, specifically medical payments or wage continuation benefits that may be paid by an automobile insurance carrier to an injured party?
MRN does not apply to first party benefits. MRN only applies to third party payments relating to the specific injury for amounts paid for Medicaid. Wage replacement is not a factor, and those funds cannot be intercepted. MRN will only collect the portion of the settlement for medical payments.
Does MRN apply to Underinsured or Uninsured Motorist claims?
No, Underinsured or Uninsured Motorist Claims are exempt from subrogation under RI law and therefore cannot be intercepted by MRN.
What will be the turnaround time when the insurance company disputes items on a lien?
There is no set time. Medicaid staff will work with insurers as always to resolve recoupments. It is our hope that using the electronic match system of MRN will streamline the process and allow full-time state staff members more time to assist and resolve disputes.
For the appeal process, is it correct that the insurer has 10 days to make payment from the date of the resolution of an appeal? Does this apply to disputes regarding items on a final lien?
Yes, payments are to be made 10 days after a decision on an appeal. Disputed items are handled on a case-by-case basis.
What are the effects of the 2006 Ahlborn Supreme Court case regarding compromising Medicaid liens with percentages?
The Ahlborn decision has the same impact on recoupments as it did before MRN.
There is a 30-day window during which a Medicaid recipient can file an intercept appeal. As an insurer, it is unlikely that we would be privy to the recipient's intentions. Should the insurer defer payment of the lien until this 30-day appeal window has elapsed?
The payment shall be held pending the appeal period. It would be possible for a claimant to waive the 30-day appeal period and allow the insurer to disburse upon signing a waiver of appeal.
If we report a claim to ISO a couple days after we receive it and are ready to make a payment in five days, can we pay our claimant or are we required to wait a certain period of time? Keep in mind we have state laws (Fair Claims Practices) that dictate how quickly we must pay claimants.
If the claimant is not a Medicaid recipient then payment can be made immediately. If they are a Medicaid recipient and you have received a lien, then the payment is not to be made until the 30-day appeal period expires, or if an appeal is requested, after the hearing on the appeal and in accordance with that decision.
How are insurers who are not members of ISO being notified?
The insurer is required to check with MRN before disbursement of funds to inquire about a claimant's Medicaid status. The MRN system will provide notices. There is also an online lookup option available on the MRN website, which can be used to check individual claims.
I have an open claim for a RI resident I want to check against the MRN database, but the claim is over one year old. What should I do?
MRN only matches with the ISO database on claims dated within the past year. If you want to check a claim that is still open and dated within the last 18 months, please use the MRN online lookup option, which you can register for on our home page. If the claim is older than July 1, 2011, you can also call MRN Customer Service and ask them to check it against an older RI recipient database.