ABOUT MARC
The Medicare Advocacy Recovery Coalition's (MARC) purpose is to:
- Ensure that Medicare beneficiaries receive coordinated and uninterrupted coverage and timely payment of settlements involving secondary payer issues;
- Facilitate national level coordination, collaboration, and communication among the member organizations regarding Medicare reimbursement and recovery policy;
- Formulate policy recommendations to affect the member interests with respect to Medicare reimbursement and recovery procedures; and
- Develop and implement legislative and regulatory strategy to enhance Medicare reimbursement and ensure that the secondary payer program works effectively, efficiently and economically.
INITIAL POLICY AGENDA – REPORTING REFORM
MARC's initial policy agenda was focused on advocating for a moratorium on the implementation of the Medicare Secondary Payer Reporting Process. In December 2007, Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA) created new and extremely complicated data reporting requirements for insurers, self-insureds, and workers compensation carriers who settle claims with Medicare beneficiaries. The rules essentially were designed to ensure that Medicare under the Center for Medicare and Medicaid Services (CMS) is aware of cases where it can assert MSP claims.
Some of the complex rules associated with Section 111 are:- Many data elements that CMS is requesting are not reliably available
(Ex: Medicare Beneficiaries social security numbers) - Under the current system, CMS may be collecting unmanageable amounts of data and currently has no solutions on how to address existing class actions. MARC proposed the development of a reporting threshold to assure that only relevant data is collected.
- Timeline for companies to prepare their computer systems and infrastructure by July 1, 2009 is limited. Impossible for stakeholders to have the technology and personnel to collect and report the many data elements by CMS's deadline.
MARC worked collaboratively with CMS officials and Congressional leaders to propose a delay on the MSP reporting process for non-group health plans.
RECENT ACCOMPLISHMENTS
As a result of significant MARC advocacy before both CMS and the Congress, in March 2009 CMS announced that it was extending implementation of the MSP reporting process by six months, until January 1, 2010 and that it would impose an interim reporting threshold for liability claims of $5,000, below which claims need not be reported into the new system. Since then, CMS has extended the implementation until April 1, 2010, and clarified that only claims data beginning January 1, 2010 need to captured. Through MARC's advocacy the Coalition has met with considerable success in ensuring that the Section 111 reporting process is implemented in a reasonable and rational manner.