From: The Honorable David G. Reichert
Sent By: Colin.Swanson@mail.house.gov
We urge you to cosponsor the Medicare Secondary Payer and Workers’ Compensation Settlement Agreement Act, H.R. 1982. This bipartisan legislation aims to resolve delays and provide clear and consistent standards for an administrative process that offers reasonable protections for injured workers and Medicare. Currently, workers’ compensation settlements that overlap with Medicare coverage are subject to a lengthy, cumbersome review by the Centers for Medicare and Medicaid Services (CMS) to determine appropriate “set-aside” coverage amounts for future medical expenses. Our proposal would:
Establish clear criteria for when a future medical set-aside may be reviewed by Medicare;
Create certainty for calculating the amounts to be included in set-asides;
Provide a reasonable time frame in which CMS is to review set-aside submissions;
Provide an appeals process for parties to CMS determinations;
Provide an optional direct payment of set-aside amounts to Medicare;
Assure that settlements that meet the terms of federal statute at the time of settlement are not disapproved based on later changes in law, regulations or administrative interpretations by CMS;
Provide for an alternative “safe harbor” option under which the parties to a workers’ compensation settlement could make payment of a percentage of a total settlement amount directly to CMS to cover Medicare set-aside responsibilities related to the settlement.
The Medicare Secondary Payer and Workers’ Compensation Settlement Agreement Act is supported by the American Insurance Association; American Bar Association; National Council of Self-Insurers; Property Casualty Insurers Association of America; UWC – Strategic Services;the Workers Injury Law and Advocacy Group (WILG); and National Association of Mutual Insurance Companies (NAMIC). To cosponsor please contact Colin Swanson in Rep. Reichert’s office (firstname.lastname@example.org or ext. 5-7761), orLakesia Foster in Rep. Thompson’s office (email@example.com or ext. 5-3311).
DAVE REICHERT MIKE THOMPSON
Member of Congress Member of Congress