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SMART Act could speed settlement of workers comp claims in 2013

SMART Act could speed settlement of workers comp claims in 2013

The recently passed Strengthening Medicare and Repaying Taxpayers Act could help speed the settlement of workers compensation claims in 2013, industry observers say.

H.R. 1845 was signed into law by President Barack Obama this month after being approved by Congress in the last week of December. The bill's passage was supported by members of the Risk & Insurance Management Society Inc., said Carolyn M. Snow, board liaison to the External Affairs Committee for New York-based RIMS.

The bill contains portions of H.R. 1063, the SMART Act, which aims to simplify the process of reimbursing the Centers for Medicare and Medicaid Services. CMS holds insurers and self-insured employers responsible to pay for a Medicare beneficiary's medical treatment related to workers compensation or liability cases.

SMART Act supporters say the bill will help the settlement of claims by requiring CMS to issue its final demand for reimbursement prior to a workers comp or liability settlement agreement. It also establishes a minimum threshold for settlements in which CMS can seek Medicare reimbursement, and includes a three-year statute of limitations for CMS to seek reimbursement from a settled claim.

“I think it will make the (settlement) process just move more smoothly,” said Ms. Snow, who is the Louisville, Ky.-based director of risk management for Humana Inc. “It eliminates a lot of the busywork, if you will, and it gives the companies more confidence in their settlements.”

Jay Fahrer, Washington-based government relations director for the Self-Insurance Institute of American Inc., said the SMART Act will help insurers and self-insureds to know how much money should be paid to CMS for reimbursement at the time of settlement, rather than waiting for CMS to send a bill before a claim is closed.

“I think that (SIIA members) spent a lot of time trying to figure that out, but there was also sort of the threat or the fear of noncompliance with coming up with the wrong total,” Mr. Fahrer said. “I think that part of the new law is very appreciated by the plans.”