MARC COALITION APPLAUDS REPS. MURPHY, KIND ON BIPARTISAN BILL TO IMPROVE MEDICARE SECONDARY PAYER POLICY
The Medicare Advocacy Recovery Coalition (MARC) today lauded Rep. Tim Murphy (R-PA) and Ron Kind (D-WI) for their introduction of the Secondary Payer Advancement, Rationalization, and Clarification (SPARC) Act (H.R. 1122) – a bipartisan measure to improve the Medicare Secondary Payer (MSP) program in Medicare Part D. While the MSP policy is designed to ensure that the Medicare program and prescription drug plans (PDPs) do not reimburse healthcare expenses for which another entity is legally responsible, literally every stakeholder agrees that the process by which PDPs recapture payment for claims that were not its responsibility to pay is broken. The SPARC Act will significantly improve the efficiency of the current system, providing a clear framework for communication among all stakeholders involved.
Medicare Advantage Plans (MAPs), also known as Medicare “Part C,” are private insurance plans that provide a Medicare beneficiary’s “Part A” and “Part B” benefits. A Medicare beneficiary can choose to enroll in a MAP rather than traditional Medicare. Part D plans provide benefits for a Medicare beneficiary’s prescription drugs. It is important to note that traditional Medicare generally does not provide prescription coverage directly; a beneficiary must enroll in a Part D plan to receive Part D benefits.
Over the past year, I've been able to learn a lot about the Medicare Advocacy Recovery Coalition (MARC), an organization consisting of representatives from all over the workers' comp industry - carriers, TPAs, comp service providers, attorneys, employers, and more.
Greg McKenna, Vice President and Counsel for Gallagher Bassett Services, invited me to attend a MARC meeting at the WCI Conference in Florida last year. To say I was impressed would be an understatement. This group of men and women - who on most days are competing against each other for business - come together on a regular basis to advocate for the improvement of MSP programs - something that affects us all.
MARC Coalition Applauds Bipartisan Senate Letter to CMS Urging Prompt Implementation of the Strengthening Medicare and Repaying Taxpayers (SMART) Act
WASHINGTON, July 17, 2014 /PRNewswire-USNewswire/ -- The Medicare Advocacy Recovery Coalition (MARC) applauds the United States Senate for its bi-partisan letter to the Center for Medicare and Medicaid Services (CMS), urging the Agency to implement promptly the Strengthening Medicare and Repaying Taxpayers (SMART) Act, signed into law on January 10, 2013. Under the legislation, CMS by October 2013 was to have implemented an electronic “portal” for the exchange of final conditional payment information, and was by July 10, 2014 to have eliminated the use of full Social Security numbers in the MSP Reporting process. Seven Senators, led by Senator Rob Portman (R-OH), urged the Agency to promptly and swiftly implement the changes required by the law.
The U.S. Centers for Medicare and Medicaid Services will officially merge the Coordination of Benefits and Medicare Secondary Payer Recovery teams into a single unit, which should save workers' compensation attorneys several phone calls a year on conditional payment issues.
The Centers for Medicare and Medicaid Services on Thursday announced plans to seek comments on proposed rules to implement the first appeals process for insurers and self-insured employers targeted for recovery actions in workers' compensation, liability and no-fault settlements to meet the requirements of the Strengthening Medicare and Repaying Taxpayers (SMART) Act of 2012.
The Centers for Medicare and Medicaid Studies is seeking proposals on how it should penalize insurers who violate the agency's claim-reporting requirements, and payers are responding that the agency should not penalize insurers who are making a good-faith effort to send the agency their data.
Law360, New York (August 09, 2012, 1:53 PM ET) -- A Medicare patient injured in an automobile accident urged the Supreme Court on Tuesday to determine whether Medicare can recover its entire payment when a beneficiary settles a tort or other claim for a reduced amount, claiming it could change how Medicare patients pursue personal injury lawsuits.
The federal government overstepped its Medicare Secondary Payer Act authority when it sought recovery of all of its costs of caring for a Medicare beneficiary from that beneficiary’s third-party settlement, the beneficiary argued in a brief filed with the U.S. Supreme Court Aug. 7 (Hadden v. United States, U.S., No. 11-1197, reply brief filed 8/7/12).