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RIMS makes SMART Act recommendations


The Risk & Insurance Management Society Inc. has made its recommendations concerning tax penalties on organizations that fail to comply with the SMART Act, including seeking a clear definition of noncompliance consistent with Medicare Secondary Payer statutes and regulations.

The recommendations were in a letter RIMS President Carolyn M. Snow submitted Tuesday to the Department of Health and Human Services' Centers for Medicare and Medicaid Services.

Other recommendations by New York-based RIMS include clearly defining metrics to determine the extent of monetary penalties, a sliding scale of monetary penalties and a safe harbor for entities that make a good faith effort to obtain pertinent information from beneficiaries or claimants.

Signed into law in January 2013, the Strengthening Medicare and Repaying Taxpayers Act includes several provisions meant to simplify the Medicare reimbursement process, typically related to claim settlements and judgments.

“For many years, RIMS was a strong supporter of the SMART Act and we applauded its passage in 2012,” wrote Ms. Snow, who also is director of risk management for Louisville, Ky.-based Humana Inc.

“Many of our members regularly handle cases involving conditional payments and are thus intimately familiar with the MSP process.” RIMS believes the SMART Act “was necessary to streamline settlements,” Ms. Snow wrote, and to correct previously “unworkable” information collection requirements.