With all of the headlines about mass dysfunction in federal politics and the endless deadlock, it is easy to become disillusioned about the process. Yet, for that very reason, it is important to share information about those times (perhaps too few and far between) where bipartisan effort does work to pass needed reform. That was recently evidence by the President’s signature on a new piece of legislation that may affect all those who rely on Medicare support and who may be harmed by the misconduct of others.
The SMART Act
The head of the American Association for Justice recently shared information on the passage of a bill known as the SMART Act. It stands for Strengthening Medicare and Repaying Taxpayers Act. In general, the bill changes the operation of the Medicare Secondary Payer (MSP) system to make it more streamlined and efficient.
The MSP system is the program that the Centers for Medicare and Medicaid Services (CMS) use to collect repayment in situations where a third party is liable. This is a common issue in many injury cases, and harmful complications with the system is something that our Chicago medical malpractice lawyers know well.
The basic idea is straightforward. Medicare pays for medical care for participants. But sometimes those payments are owed by third parties–like another insurance company or an individual who was negligent and caused the participant’s injuries. In those cases, Medicare, while paying for the initial coverage, seeks repayment from the party that is actually liable.
This seems simple enough, but problems often arise. That is because the current MSP system is often grossly inefficient and marred in time delays. The practical reality is that there are often months or even years of delay before Medicare officially indicates its costs and allows for reimbursement. That delay may have serious implications on an injury victim who may be waiting for that Medicare guidance before having access to the funds in a damage award.
Attorneys working on these cases understand intimately how these delays can make life very difficult for those harmed by another’s negligence. It is hard enough dealing with the medical issues following the event, but having the Medicare system dawdle and delay financial compensation on top of it is incredibly unfortunate. This inefficiency also proves problematic for taxpayers, as the federal coffers are often affected by the slow process currently available to recoup taxpayer funds.
Fixing the MSP System
Fortunately, the SMART Act seeks to change all of that by offering different rules that CMS must use when requiring reimbursement for payments owed by a third party. Most notably, a protected online service will be created which will require CMS officials to upload information about care payments within 15 days. In addition, there are changes to the way that CMS officials will obtain information about reimbursement amounts. Medicare beneficiaries must submit information to CMS officials in a timely manner, and then the officials have a set amount of time to ensure that the web information is updated accurately.
All of this is great news for all parties involved. Hopefully the necessary infrastructure changes are made soon at CMS so the process can take effect in the near future.
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