Problems with Medicare Secondary Payer
- No Speedy Resolution: Currently, CMS does not respond timely to requests for reimbursement amounts. This can mean the Medicare reimbursement process can drag on for years.
- Inefficiency: Often CMS requests payments multiple times for different amounts. They may request additional payment years after you have already provided reimbursement from a legal settlement. This makes it impossible to settle legal claims with confidence.
- Uncertainty: Currently, CMS does not provide a final demand letter (reimbursement amount) until after the parties have entered into a legal settlement agreement. This makes it impossible to settle legal disputes because Medicare beneficiaries are unable to determine how much they have to reimburse Medicare. Parties need to know the full value of a claim so that they may be able to successfully negotiate a fair legal settlement.
H.R. 1063: The Strengthening Medicare and Repaying Taxpayers (SMART) Act
Bi-partisan legislation, H.R. 1063, has been introduced into the House by Reps. Tim Murphy (R-Pa.) and Ron Kind (D-Wis.) with support from both AAJ and a diverse coalition of businesses, Medicare Advocacy Recovery Coalition (MARC).
H.R. 1063 would:
- Require Medicare 65 days to respond to an inquiry regarding a reimbursement claim
- Clarify a three year statute of limitations on MSP claims
- Develop an appeals process
- Create a threshold amount for reporting claims, ensuring claim amounts are higher than the cost associated to obtain those claims
- Protect seniors social security numbers by utilizing another means of identification
Protecting Medicare with Improvements to the Secondary Payer Regime Hearing, House Energy and Commerce Oversight Subcommittee