Federal Legislation Introduced to Improve Problems with Medicare’s Secondary Payer System

Our Illinois nursing home lawyers have previously explained the problems faced by seniors because of inefficiencies within the Medicare Secondary Payer (MSP) system. The goal of the program is ensuring that the Medicare program (and taxpayers) are reimbursed for costs that others have a primarily responsibility in paying. However, the bureaucracy is so thick with the MSP system that millions and millions of dollars are lost trying to navigate its complexities. Various groups are adversely affected by the bureaucratic nightmare include small businesses, insurance companies, municipalities, and even other federal agencies. Worst of all, many senior participants in the system have also suffered clear harm because of the problems. Our Chicago nursing home attorneys have watched as many of these victims have been left unable to pay bills or have been attacked by creditors because of MSP problems.

The MSP system has been made very difficult to navigate over the years because of frequent mistakes and slow resolutions to issues. The problem has only worsened as of late. In 2007 even more additional reporting requirements were enacted which slowed the process down again and made it even more difficult than it already was for users to figure out what they had to do. Many seniors who have been injured in a variety of incidents, from car accidents to nursing home falls, are rarely able to receive quick and timely answers from the MSP system about how much money will need to be paid back. This makes it difficult to properly account for such costs in settlement negotiations. Even after settlement is reach the Medicare system often makes inaccuracies which demand more money be paid back than care that was provided. These disputes often delay for years, seniors receiving money that they are owed, and occasional mistakes result in senior victims having their social security checks docked by overzealous Centers for Medicare and Medicaid (CMS) officials.

The problems have long needed to be fixed. Fortunately, a step in the right direction was announced yesterday as a bipartisan group of legislators proposed a bill to improve the system. Known as “Strengthening Medicare and Repaying Taxpayers (SMART) Act, the bill is meant to enact changes to streamline the MSP system and provide relief for all those involved-which often includes Illinois nursing home neglect victims and their families. The bill would force Medicare to fully disclose the amount that it must be repaid before a final settlement is reached by the parties. In addition, the legislation would put a three year cap on the time that Medicare can pursue claims on certain claims. Those affected claims are so small that they cost the MSP system more to pursue than they actually collect. The group of Republican and Democrat senators who are sponsoring the measuring explained that the measure will help taxpayers collect millions of dollars that they are owed every year, while ensuring seniors are not denied benefits to which they are entitled. All those who work with senior victims of accident or abuse, including nursing home abuse lawyers, will likely urge passage of this common sense message.

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