Printed from

Medicare reform bill backers see benefits for workers comp

Posted On: Apr. 22, 2012 12:00 AM CST

PHILADELPHIA—A bill pending in Congress could help resolve Medicare Secondary Payer system problems that hinder settling workers compensation and liability claims, advocates of the legislation say.

H.R. 1063, the Strengthening Medicare and Repaying Taxpayers Act, aims to simplify the Medicare reimbursement process for claim settlements and judgment awards under the Medicare secondary payer law. The issue affects beneficiaries who have received Medicare-funded medical services or are likely to receive them in the future, and are expected to set aside settlement money to repay the Medicare Trust Fund.

The legislation was discussed at the Risk & Insurance Management Society Inc. conference in Philadelphia during a session titled “How to Fix the Medicare Secondary Payer Act.” The SMART Act was referred to the House Energy and Commerce committee last year.

U.S. Rep. Tim Murphy, R-Pa., who introduced the bill in March 2011, said litigants often are reluctant to settle lawsuits because it is unclear how much of the award should be set aside for Medicare reimbursements.

He told the audience that it is important to simplify Medicare Secondary Payer compliance so plaintiffs can receive settlement benefits as soon as possible.


“Some of these people are in ill health and rely on a settlement to pay their bills,” Rep. Murphy said, speaking to RIMS attendees by phone. “If we enact the SMART Act, those senior citizens would receive what is rightfully theirs now.”

Among several provisions, the SMART Act would require litigation parties to request a final bill from the Centers for Medicare and Medicaid Services, which would detail how much money a beneficiary would need to pay to Medicare out of his or her settlement.

CMS generally would be required to provide that statement within a 65-day window, allowing parties to pay the amount immediately and close the beneficiary's liability or workers comp claim.

Attorney David Farber, counsel for the Washington-based Medicare Advocacy Recovery Coalition, said Medicare Secondary Payer reform proponents have aimed to make the SMART Act “short, simple and realistic” in hopes of helping the bill pass.

“It is an incredibly efficient, focused and appropriate process where everyone gets what they should be getting in time,” said Mr. Farber, a partner with Washington-based law firm Patton Boggs L.L.P.


The bill has received support from various interest groups—including businesses and trial lawyers—who want to promote litigation settlements while ensuring that the Medicare Trust Fund maintains the funding it needs, said MARC co-chair Roy Franco.

“The right thing to do is to pay back Medicare, but to do it in a way that makes sense and works well,” Mr. Franco said.

Panelists said backers of H.R. 1063 aim to reach 190 co-sponsors for the bill in order to improve the bill's chance of passing. The bill had 99 co-sponsors as of last week.

Panelists encouraged attendees to contact legislators in their states and ask them to co-sponsor H.R. 1063.