The SMART Act was signed by President Obama on January 10, 2013 after it had passed in both branches of Congress. The act amends portions of the Medicare Secondary Payer (MSP) statute and is intended to simplify portions of the statute that have been considered onerous to beneficiaries.

An excellent overview of the act was prepared by MEDVAL, a company that provides pre-settlement and post-settlement services for liability claims that involve protecting Medicare’s interests. Here are the highlights.

Timeline

  • 60 days: CMS shall solicit public comments in Federal Register regarding creation of regulations for reporting penalties.
  • July 2013: Reporting penalty discretionary & US limited to 3 year SOL if pursuing private cause of action under 1395y(b)(2)(B)(iii) in recovery of reported NGHP TPOCs.
  • October 2013: Conditional payment final determinations may be made through web portal & appeal available to NGHPs.
  • November 15, 2013: CMS must determine recovery exemption, obtain review of Comptroller General & report to Congress by this date.
  • 2014: MSP recovery exemption available.
  • July 2014: CMS deadline to find SS# alternative (possibility of 1 year extensions).

Social Security Numbers Implementation: TBD

The Secretary of The Department of Health and Human Services has 18 months to propose an alternative method to the use of Social Security numbers for purposes of mandatory insurer reporting. This period may be extended by one or more periods of up to a year if the Secretary notifies Congress that absent such an extension that patient privacy or integrity of the MSP program is threatened. Until such a time as a viable alternative is established, RREs shall continue to use Social Security or health insurance claim numbers (HICNs) in their quarterly reporting.

For questions about the SMART Act, contact Jon Gunter, Medval’s West Coast executive vice-president, at jgunter@medval.com, 888-738-2743.

 

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