5-12-2011; UPDATE—Will changes to the Medicare Secondary Payer Statute assist in resolving Medicare issues and finally give us a way to appeal what are sometimes incomprehensible MSA values?

As previously reported, on March 14, 2011, the Strengthening Medicare and Repaying Taxpayers Act of 2011 (SMART Act) (H.R. 1063) was introduced in the U.S. House of Representatives. The SMART Act proposes major amendments to the Medicare Secondary Payer Statute (MSP) including

  • Require CMS to respond  to requests  for conditional payment information within set timelines
  • Provide MSP appeal rights
  • Set MSP threshold exemptions
  • Set MSP statute of limitations

Track progress here: http://www.govtrack.us/congress/bill.xpd?bill=h112-1063       

In semi-related news, Sens. Dick Durbin (D, Ill.) and John Cornyn (R, Texas) introduced versions of Medicare transparency bills on April 14. Sens. Charles Grassley (R, Iowa) and Ron Wyden (D, Ore.) introduced a joint transparency bill earlier in April and even though the three bills are different, all would accomplish the same goal of opening billions of claims filed by health professionals every year to public scrutiny. We will continue to keep you advised of updates as they occur and as previously noted, Shawn R. Biery has been granted the Medicare Set-aside Consultant Certified (MSCC) credential.


Please feel free to contact Shawn R. Biery, J.D., M.S.S.C. at sbiery@keefe-law.com with any questions regarding Medicare Set-Aside issues.