Congress approved the Medicare Modernization Act, (15) which amended the Medicare Secondary Payer Act's definition of self-insurance and deleted "prompt payment" language from section (A)(ii) of the Act.
Previously, Walker was senior associate counsel at Great-West Healthcare, where he served as lead attorney, advising healthcare business units on COBRA, Cal-COBRA, HIPAA, ERISA, prompt pay, MEWAs, Coordination of Benefits and Medicare Secondary Payer claims.
The bill seeks to resolve the serious delays and confusion in the review of workers' compensation Medicare set- asides by CMS, says to Melissa Shelk, AIA vice president for federal affairs, and Douglas Holmes, president of Strategic Services on Unemployment and Workers' Compensation (UWC) and coordinator of the Coalition for Medicare Secondary Payer Reform.
The Medicare Secondary Payer Act (MSP) prohibits Medicare from making payments if payment has been made or is reasonably expected to be made by a workers' compensation plan, liability insurance, no-fault insurance, or a group health plan.
To reduce Medicare costs, Congress enacted a collection of statutory provisions in the 1980s called the Medicare Secondary Payer, or MSP, statute, largely in recognition that workers' compensation carriers should be the primary source of medical insurance coverage for people injured on the job.
The bills would "amend the Social Security Act to eliminate the time limitation on benefits for immunosuppressive drugs under the Medicare program, to provide continued entitlement for such drugs for certain individuals after Medicare benefits end, and to extend certain Medicare secondary payer requirements.
To promote the Department of Health and Human Services's (HHS) ongoing program to make Medicare a secondary payer under the Medicare Secondary Payer statute and to provide assistance to those states seeking to make Medicaid a secondary payer, the Omnibus Budget Reconciliation Act of 1993 (of which the RRA is a part) creates a new Medicare and Medicaid Coverage Data Bank and requires employers providing group health plans to report information for each calendar year beginning Jan.