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A bill that aims to ease common problems with Medicare Secondary Payer Act compliance has passed the House of Representatives as part of a larger legislative package.
Provisions of H.R. 1063, the Strengthening Medicare and Repaying Taxpayers Act, were passed Wednesday as part of H.R. 1845, the Medicare IVIG Access Act. The parent bill would study access to intravenous immunoglobulin for Medicare beneficiaries.
The combined legislation passed 401-3, according to the Washington-based American Insurance Association. It has been sent to the Senate for further consideration.
Proponents of the SMART Act say it would help simplify the process of reimbursing the Centers for Medicare and Medicaid Services. CMS holds insurers and self-insureds responsible to pay for a Medicare beneficiary's medical treatment related to workers compensation or liability cases. But CMS does not tell settlement parties how much is owed for Medicare reimbursement until after a settlement has been reached.
Observers have said this procedure prevents comp and liability claims from being closed as they await a “final demand” letter from CMS.
The SMART Act would require CMS to issue its final demand prior to a workers comp or liability settlement agreement.
It also would establish a minimum threshold for settlements in which CMS can seek Medicare reimbursement, and would set a three-year statute of limitations for CMS to seek reimbursement from a settled claim.
“Enactment of the SMART Act will produce a triple win. Medicare beneficiaries will be able to settle claims, companies will be able to resolve disputes faster and more efficiently, and the Medicare Trust Fund will be repaid quicker and more efficiently,” said Roy Franco, co-chair of the Washington-based Medicare Advocacy Recovery Coalition, in a statement.
The Congressional Budget Office estimated in November that the SMART Act would reduce Medicare spending by $45 million from 2013 to 2022.
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.