SMART Act Revises Secondary Payer Process, Affects MMSEA Compliance

January 16, 2013 | Strategic Insights for Health System


The Strengthening Medicare and Repaying Taxpayers (SMART) Act, which President Obama signed into law on January 10, 2013, revises certain aspects of the Medicare secondary payer process and affects compliance under section 111 of the Medicare, Medicaid, and SCHIP (State Children's Health Insurance Program) Extension Act of 2007 (MMSEA). Among other changes, the legislation allows for a new conditional payment resolution process, in which Medicare lien amounts will now be available prior to settlement. The Centers for Medicare and Medicaid Services (CMS) is expected to finalize the regulations for the new process within nine months. The SMART Act also contains exemptions related to the threshold amount below which Medicare will not seek reimbursement of conditional payments. This threshold, which the secretary of the Department of Health and Human Services must calculate and publish by November 15 each year, will be based on the estimated cost of collection incurred by the U.S. government.

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