On January 9, 2012, the President signed the Strengthening Medicare and Repaying Taxpayers (SMART) Act into law. The SMART Act represents one of the most significant changes to the conditional payment recovery process since the MSP Statue was enacted.
The SMART Act amends the Medicare Secondary Payer Statue by adding the following language at the end of the existing statute:
- Section 201 - Expedited Repayment, Web Portal and Right of Appeal. This section requires CMS to maintain and make available a timely updated website so settling parties can determine how much is owed to CMS for conditional payments, during the settlement process. It also requires CMS to provide a timely appeals process and to promulgate related regulations, if the settling parties believe there is a discrepancy in the conditional payment statement.
- Section 202 - Threshold. Establishes that an actuarial single threshold amount be set for exemption from conditional payment reimbursement, where the expected recovery amount is less than the cost to recover.
- Section 203 - Section 111 Penalties. Makes the $1,000 per day Mandatory Insurer Reporting (MIR) non-reporting penalty prevision discretionary by changing the statutory language from "shall be subject" to "may be subject to". Also, this section requires CMS to publish formal regulations specifying situations where the penalty will not be imposed due to good faith efforts to comply.
- Section 204 - Social Security Number. Directs CMS to modify the MIR reporting requirements so that reporting of social security numbers are not required.
- Section 205 - Statute of Limitations. Creates a three-year statute of limitations for conditional payment recovery actions brought by the government.
MSA Services, LLC will continue to keep you apprised of all further developments.