SYS-CON MEDIA Authors: Pat Romanski, Elizabeth White, Glenn Rossman, Cynthia Dunlop, Peter Silva

News Feed Item

Medicare Advocacy Recovery Coalition (MARC) Applauds GAO On Recently Released Medicare Secondary Payer Report

 

WASHINGTON, April 11, 2012 /PRNewswire-USNewswire/-- The Medicare Advocacy Recovery Coalition (MARC) applauds the United States Government Accountability Office (GAO) for their recently released report titled "Medicare Secondary Payer - Additional Steps Are Needed to Improve Program Effectiveness for Non-Group Health Plans." This GAO report was requested by Representative Stark (D-CA-9) in August of 2010 and reflects many of the issues and solutions that MARC strongly supports in the current Strengthening Medicare and Repaying Taxpayers Act (SMART Act) – S.1718/H.R. 1063.

The GAO report concludes that the Non-Group Health Plan (NGHP) Medicare Secondary Payer (MSP) mandatory reporting process continues to face many obstacles and administrative burdens, and that the current process is impeding settlements, and harming both beneficiaries and business alike. GAO also notes that many improvements are needed to make the MSP system more cost-effective and less burdensome, and points out many specific shortcomings in the current system -- conclusions with which MARC agrees and which MARC is trying to remedy through support of the SMART Act before Congress.

Among the many findings in the report, the GAO report concludes that multiple improvements to the MSP system should be made:

  • To ensure cost-effectiveness in the NGHP recovery process, GAO recommends that CMS should review the recovery thresholds periodically to ensure that recovery efforts are "being conducted in the most cost-effective manner possible." GAO also recommends that CMS should not require NGHPs to report MSP cases which the Agency would not pursue for recovery. This recommendation mirrors the SMART Act's threshold legislation.
  • To facilitate settlements GAO acknowledges the difficulties settling parties have in not receiving a final demand from the Agency. Again, the SMART Act would solve this issue.
  • GAO also noted the unfairness of CMS's insistence on taking 100% of settlement funds without any allocation. While not the subject of pending legislation, the MARC coalition has supported recent efforts before the Supreme Court to clarify this question.
  • In discussing the issues and inefficiencies in the current MSP system, GAO notes that CMS has taken some, but not enough, steps to address some of these concerns. Others cannot be changed by the Agency, but must be fixed by the Congress through legislation.

"We are pleased that GAO has focused attention on this issue which is important to beneficiaries and businesses alike," said Roy Franco, co-chair of the MARC Coalition. MARC urges CMS to seriously review the report and adopt all its recommendations," said Dean Pappas, co-chair of the Coalition. "While some changes can only be achieved through legislation like the SMART Act, the Agency should do what it can today to ameliorate the unnecessary burdens on both industry and beneficiaries trying to settle these claims," said Pappas.

The SMART Act, H.R. 1063 and S.1718, is the first comprehensive MSP reform legislation to be introduced into both chambers of Congress. To date the legislation has extensive bi-partisan support, with 98 co-sponsors in the U.S. House of Representatives and 15 co-sponsors in the Senate.

About MARC:
The Medicare Advocacy Recovery Coalition (MARC) advocates for the improvement of the Medicare Secondary Payer (MSP) program for beneficiaries and affected companies. The Coalition collaborates and develops strategic alliances with Congressional leaders and government agencies to focus on implementation of MSP reporting, and on the broader issue of MSP reform. MARC's membership is comprised of entities representing virtually every sector of the MSP regulated community including attorneys, brokers, insureds, insurers, insurance and trade associations, self-insureds and third-party administrators. For more information on MARC and the SMART Act/H.R. 1063, please visit www.marccoalition.com.

 

 

SOURCE Medicare Advocacy Recovery Coalition

More Stories By PR Newswire

Copyright © 2007 PR Newswire. All rights reserved. Republication or redistribution of PRNewswire content is expressly prohibited without the prior written consent of PRNewswire. PRNewswire shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

Latest Stories
Samsung VP Jacopo Lenzi, who headed the company's recent SmartThings acquisition under the auspices of Samsung's Open Innovaction Center (OIC), answered a few questions we had about the deal. This interview was in conjunction with our interview with SmartThings CEO Alex Hawkinson. IoT Journal: SmartThings was developed in an open, standards-agnostic platform, and will now be part of Samsung's Ope...
Explosive growth in connected devices. Enormous amounts of data for collection and analysis. Critical use of data for split-second decision making and actionable information. All three are factors in making the Internet of Things a reality. Yet, any one factor would have an IT organization pondering its infrastructure strategy. How should your organization enhance its IT framework to enable an In...
The major cloud platforms defy a simple, side-by-side analysis. Each of the major IaaS public-cloud platforms offers their own unique strengths and functionality. Options for on-site private cloud are diverse as well, and must be designed and deployed while taking existing legacy architecture and infrastructure into account. Then the reality is that most enterprises are embarking on a hybrid cloud...
In her General Session at 15th Cloud Expo, Anne Plese, Senior Consultant, Cloud Product Marketing, at Verizon Enterprise, will focus on finding the right mix of renting vs. buying Oracle capacity to scale to meet business demands, and offer validated Oracle database TCO models for Oracle development and testing environments. Anne Plese is a marketing and technology enthusiast/realist with over 19...
StackIQ offers a comprehensive software suite that automates the deployment, provisioning, and management of Big Infrastructure. With StackIQ’s software, you can spin up fully configured big data clusters, quickly and consistently — from bare-metal up to the applications layer — and manage them efficiently. Our software’s modular architecture allows customers to integrate nearly any application wi...
As Platform as a Service (PaaS) matures as a category, developers should have the ability to use the programming language of their choice to build applications and have access to a wide array of services. Bluemix is IBM's open cloud development platform that enables users to easily build cloud-based, creative mobile and web applications without having to spend large amounts of time and resources o...
The Internet of Things will greatly expand the opportunities for data collection and new business models driven off of that data. In her session at Internet of @ThingsExpo, Esmeralda Swartz, CMO of MetraTech, will discuss how for this to be effective you not only need to have infrastructure and operational models capable of utilizing this new phenomenon, but increasingly service providers will nee...
When you set off to build an app that will change the world, designing your system architecture to be reliable and scalable is important but the stark reality is that, for your MVP, you probably had a “need for speed” (of development). You didn’t know what all the axes were to scale your application, where your stress points would be, and what weird and wonderful ways your customers would use it d...
Compute virtualization has been transformational, yet security policy implementation and enforcement has lagged behind in agility and automation. There are a number of key considerations when implementing policy in private and hybrid clouds. In his session at 15th Cloud Expo, Holland Barry, VP of Technology at Catbird, will discuss the impact of this new paradigm and what organizations can do to...
SYS-CON Events announced today that Red Hat, the world's leading provider of open source solutions, will exhibit at Internet of @ThingsExpo, which will take place on November 4–6, 2014, at the Santa Clara Convention Center in Santa Clara, CA. Red Hat is the world's leading provider of open source software solutions, using a community-powered approach to reliable and high-performing cloud, Linux, ...