Capitol Bridge Awarded WCRC Contract


On September 1, 2017, the Centers for Medicare and Medicaid Services (CMS) announced the award of the WCRC contract to Capitol Bridge, LLC (Capitol Bridge).  CMS began the contract renewal process back in December 2016 searching for an entity to “independently price the future Medicare-covered medical services costs related to WC injury, illness and disease, and to price the future Medicare covered prescription drug expenses.” Capitol Bridge, designated as a minority owned business, was awarded the new $60.7 million contract until August 31, 2018. The award to Capitol Bridge replaces the current contractor Provider Resources, Inc. which has held the WCRC contract since 2012.

There are many questions that arise with this long awaited award of the WCRC contract.  Will the change of contractor from PRI to Capitol Bridge produce any changes to the current WCRC review and re-review processes?  Will the change impact turn-around times for approvals?  Will the new contractor finally execute CMS’ vision for a Liability and No Fault MSA review process?  These questions and more will only be answered over time.

ExamWorks Clinical Solutions will monitor the implementation of the new WCRC contractor, Capitol Bridge, and any effects that may have on the WCRC MSA review process.