I previously discussed H.R. 4796 in one of my posts. H.R. 4796 is a piece of legislation currently in the House and is entitled the Medicare Secondary Payer Enhancement Act of 2010. The legislation is designed to streamline the MSP process and correct some of the major problems with delays in resolution of conditional payments.
The bill now has 32 co-sponsors in the House ranging from Rep. Wrangle to Rep. McCarthy. It has broad based support from Republicans and Democrats alike. A Democrat sponsor in the Senate has been identified but so far no Republican sponsor has been identified. It is pending a CBO score. However, it was privately scored as cost neutral. There is some doubt as to whether it will get passed before the end of the year given the mid-term elections. If it is not passed in 2010, there are plans to re-introduce the legislation early in 2011.
Summary of HR 4796 by Congressional Research Service
3/9/2010--Introduced.
Medicare Secondary Payer Enhancement Act of 2010 - Amends title XVIII (Medicare) of the Social Security Act with respect to any settlement, judgment, award, or other payment between a Medicare claimant and an applicable plan involving a payment made for items and services by the Secretary of Health and Human Services (HHS). Prescribes requirements for a voluntary calculation and direct reimbursement by a Medicare claimant and an applicable plan to the Hospital Insurance Trust Fund or the Supplementary Medical Insurance Trust Fund, as appropriate, of a conditional payment of Medicare secondary payer claims for settlement purposes. Grants the Secretary the right to contest the amount of any such reimbursement, and the right of the claimant and plan to request a final recovery demand for reimbursement. Declares that requirements to reimburse the appropriate Trust Fund for any payment made by the Secretary with respect to an item or service shall not apply with respect to any settlement, judgment, award, or other payment by an applicable plan: (1) constituting a total payment obligation to a claimant of not more than $5,000; or (2) involving the ongoing responsibility for other medical payments of not more than $5,000.
Changes from mandatory to discretionary the current civil money penalty for failure of an applicable plan to submit certain information to the Secretary with respect to any claimant. Prescribes requirements for the creation of safe harbors from such sanctions. Directs the Secretary to modify reporting requirements for liability insurance (including self-insurance), no fault insurance, and workers' compensation laws and plans so that entities responsible for reporting information are not required to access or report to the Secretary beneficiary Social Security numbers or health identification numbers. Sets a statute of limitations with respect to the recovery of payments by the United States. Establishes $30 user fees, adjusted annually for inflation, for requests submitted to the Secretary for direct conditional payment reimbursement and for final demand of a conditional payment.