HR 1063: the smart act

In March 2011, Congressman Tim Murphy (R-PA) and Ronald Kind (D-WI) introduced HR 1063, a bill titled the “Strengthening Medicare and Repaying Taxpayers Act of 2011” (a/k/a the SMART ACT). This piece of legislation proposes a more streamlined approach to obtaining conditional payment amounts from Medicare under the Medicare Secondary Payer (“MSP”) Act. Additionally, this bill offers Medicare discretion in imposing penalties on non-complying entities under the recently enacted Medicare, Medicaid and SCHIP Extension Act of 2007 (“MMSEA”).

We, at the Garretson Resolution Group (“GRG”) provide this practice tip as part of our commitment to keep our clients informed of the latest developments in health-care lien resolution. We will continue to follow the progress of this legislation. Please see our SMART ACT Update for our most recent client advisory on the topic.

Among the tips included in this pamphlet are:

  • What are the implications for MSP compliance if the SMART Act is signed into law?
  • Obtaining CMS’ reimbursable conditional payment amount
  • Medicare’s response
  • Notice to Medicare of failure to settle
  • Rights of appeal
  • MSP threshold exemptions
  • Reporting requirement safe harbors (Section 111’s “$1,000 a day, per claim” penalty provision)
  • MSP statute of limitations
  • Use of Social Security numbers and other identifying information in reporting