Jan. 14, 2013 – On Jan. 10, President Obama signed into law the Strengthening Medicare and Repaying Taxpayers (SMART) Act passed by Congress in December.
The SMART Act is aimed at simplifying compliance with the Medicare Secondary Payer (MSP) Act. MSP has been around since the 1980s and made Medicare the secondary payer to personal injury insurance, health insurance, and workers’ compensation plans.
MSP required parties who have settled a liability case, such as a workers’ compensation or auto accident case settlement or judgment, to determine and repay the Medicare program for any conditional payments it made on behalf of a beneficiary in connection with the liability case. This has sometimes been difficult because getting the necessary information out of Medicare is challenging, making it hard to determine how much Medicare should be paid.
The SMART Act addressed this problem by requiring CMS to establish a website whereby individuals or insurance companies can access information on claims paid by Medicare. It also requires that Medicare provide conditional payment information within 65 days of a request. Medicare is also required to respond to individual disputes regarding Medicare’s conditional payments within 11 days and to establish regulations providing appellate rights regarding his determinations of conditional payments made.
The SMART Act also establishes a three-year statute of limitations on MSP actions by Medicare to recover claims.