Washington, D.C.  — Congressional Doctors Caucus co-chair Rep. Tim Murphy (PA-18) today applauded the House Energy and Commerce Committee for its unanimous support of his Strengthening Medicare and Repaying Taxpayers Act (SMART Act, H.R. 1063). The legislation overhauls the Medicare Secondary Payer program, which is responsible for determining when another insurer must pay a senior’s medical bills.

Murphy’s bill accelerates the processing of Medicare secondary payer reimbursement from liability and workers’ compensation settlements, removes bureaucratic delays at Medicare that can jeopardize seniors’ benefits, and collects billions of dollars owed by insurance companies to the Medicare Trust Fund.

“Today’s vote is a victory for thousands of senior citizens across the United States who are awaiting settlement checks they’re entitled to,” said Congressman Murphy. “The current Medicare Secondary Payer bureaucracy is causing seniors to have their Social Security checks garnished and their Medicare coverage denied through no fault of their own. My bill not only fixes these problems so no senior will lose their health insurance because of bureaucratic error, but it also recoups billions of dollars owed by insurance companies to the taxpayers.”

Background:

Under the ‘Medicare Secondary Payer’ statute, insurers, retailers, and third parties must repay Medicare if their negligence leads to medical bills for a senior citizen. But the current system is complicated and riddled with bureaucratic delays, preventing these cases from closing and bringing in money owed to the Medicare Trust Fund.
 
The SMART Act, which has nearly 140 bipartisan cosponsors, requires Medicare provide the parties with accurate information about the total cost of medical bills when the parties announce a settlement is near. Without coming to a settlement, Medicare cannot recoup the money and beneficiaries are often left footing the bill. The SMART Act breaks down the bureaucratic hurdles that prevent Medicare and private insurers from closing out medical billing cases in a timely manner. Industry experts have suggested that Murphy’s bill could collect between $1 billion and $4 billion annually, while saving the Medicare agency countless hours of staff work pursuing claims of little or no value.

Murphy’s bill was the focus of an Energy and Commerce Committee Subcommittee on Oversight and Investigations Hearing last June. At the hearing, members learned the impact that extremely long delays have on the financial stability of Medicare and on beneficiaries who are owed settlements due to medical malpractice, liability or workers compensation. Testimony from expert witnesses revealed from those who have experienced first-hand the problems that arise with extensive delays in the system, including a compelling argument from Pittsburgh attorney Jason Matzus, who represents Medicare beneficiaries.
To read more about the hearing, click here.