On several occasions we have explained the challenges faced by some who win brain injury verdicts and settlements to actually recover their earnings. Depending on the specifics of the case, many different hoops might need to be jumped through before an injury victim actually receives their compensation and can use it to get their lives back in order.
One of those hoops is often dealing with the Medicare Secondary Payer system (MSP). Those who rely on government programs with their health insurance needs, may be forced to wait months (or even years!) before the final details of their situation are settled. That is because the MSP system is often ridiculed in delays and errors.
The MSP is implicated when the public program provides payment for a participant and then seeks to have that payment reimbursed following an injury verdict or settlement. For example, a senior who is on Medicare may be involved in a car accident and suffer a traumatic brain injury. Medicare will likely cover the associated healthcare costs for the participant in the aftermath of the accident. However, if the participant eventually receives a settlement from the negligent party in the accident, then Medicare will seek reimbursement via the MSP system.
Problems arise, though, when Medicare officials do not act in a timely fashion when seeking that reimbursement. Many injury victims are forced to wait without knowing how much of their settlement or jury verdict will be taken by Medicare. This delay is often a significant hardship on families who have already endured so much after suffering injury.
Fortunately, important changes may be on the way to fix the problems in the MSP, ensuring that injury victims are not unduly burdened while taxpayers still receive the reimbursements to which they are entitled. President Obama recently signed the SMART Act into law–Strengthening Medicare and Repaying Taxpayers Act. The bill was passed in a bipartisan fashion with both Republican and Democratic sponsors in the House of Representatives and Senate. The fact that different groups could get together on this is a testament to the important nature of the work.
The SMART Act has several different components, but all of them are focused on improving the efficiency of the MSP system. Perhaps most notably, the bill requires the Centers for Medicare and Medicaid Services (CMS) to create an online portal where, within 15 days, proper information about reimbursements must be posted. This will hopefully provide a far more efficient way for residents to get the final details of the matter resolved, pay the reimbursement amount, and get on with their lives. The Act also sets out rules for beneficiaries to let CMS officials know of settlements. In addition, it creates an appeals process that will hopefully quickly settle any discrepancies between parties in a fair manner.
Our Chicago brain injury lawyers applaud the work of federal officials who negotiated the system to get this measure passed. We encourage CMS officials to act quickly to meet the demands of the new law. Everyone wins when this process is streamlined and the efficiency is improved. Now that there is actual legal effect to those streamlining efforts, we hope that there is no delay.
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