Personal Injury attorneys are all too familiar with the delays and complications in settling a case that involves Medicare liens. The Smart Act - Strengthening Medicare and Repaying Taxpayers Act - was signed by President Obama on January 10, 2013 and changes Medicare’s secondary payer rules and processes. In an attempt to improve efficiency Medicare will now work with claimants and/or responsible parties prior to settlement via the updated CMS website. The website will be used to determine liability for conditional payment amounts. One of the changes to determining the final conditional payment is:
“…claimant may at any time beginning 120 days before the reasonably expected date of a settlement, judgment, award, or other payment, notify the Secretary that a payment is reasonably expected and the expected date of such payment.”
This notification establishes the “protected period” in which the final conditional payment will be finalized. The final conditional payment is determined by:
“…the last statement of reimbursement amount that is downloaded during such period and within 3 business days before the date of the settlement, judgment, award, or other payment shall constitute the final conditional amount subject to recovery…”
If the claimant or RRE fails to follow the timelines set out in the SMART Act the settlement and the final conditional amount will be considered to be invalid.
For more information regarding the changes HR 1845 (112th) Title II – Strengthening Medicare Secondary Payer Rule Click here: https://www.govtrack.us/congress/bills/112/hr1845/text
Final regulations to the SMART Act must be promulgated by October 10, 2013.
Senior Vice President