[net-gold] Industry Coalition Wants to Cut CMS Conditional Payments
- From: "David P. Dillard" <jwne@xxxxxxxxxx>
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- Date: Fri, 18 Mar 2011 11:56:20 -0400 (EDT)
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Date: Fri, 18 Mar 2011 11:09:06 -0000
From: JonG <jon@xxxxxxxxxxx>
Reply-To: Net-Gold@xxxxxxxxxxxxxxx
To: Net-Gold@xxxxxxxxxxxxxxx
Subject: [Net-Gold] Industry Coalition Wants to Cut CMS Conditional Payments
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Industry Coalition Wants to Cut CMS Conditional Payments
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A group of about 50 employers, insurance carriers
and vendors have formed a coalition to endorse
legislation (H.R.1063) introduced this week that
would ease reporting requirements and reimbursement
procedures of the Centers for Medicare and Medicaid
(CMS). The organization, the Medicare Advocacy
Recovery Group [MARC], contends that the proposed
legislation will:
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"Empowering Medicare to provide settling parties
with the amount of their MSP repayment obligation
during the settlement process, will allow taxpayers
to settle quicker, and repay the Medicare Trust Fund
faster.
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"MSP Reform will provide a more affordable and less
intrusive MSP system that protects beneficiaries and
the Medicare Trust Fund, but does not waste limited
judicial and other resources or needlessly confuse
parties trying to settle a claim resulting from an
injury to a beneficiary.
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"MSP Reform will also eliminate the required use of
Social Security Numbers (SSNs) and Health Insurance
Claim Numbers (HICNs) in the reporting process,
create a basic right of appeal for all parties to
resolve a CMS MSP determination, clarify the statute
of limitations, and require the CMS Actuary to
determine a threshold below which the recoveries are
so small it makes no sense to apply the complex MSP
laws.
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Theoretically it sounds like the change would create
a more efficient system to establish: time limits for
claim reimbursement; a statute of limitations for
liability (3 years); an avenue for redress directly
to the judicial system; and a threshold amount for
reimbursement. However, the proposal would actually
defeat the basic philosophy of the workers'
compensation act.
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The convoluted logic of the employer/insurance group
just makes no sense. It is like saying that I didn't
bother buying enough postage on a timely basis so I
will just mail my letter at half-price. The universal
legislative intent of workers' compensation act
mandates that the employer is responsible for medical
care of its injured workers. The insurance industry
has tried other gimmicks before to continue its long
history of cost shifting, and those have rightly
failed as Congress wouldn't buy into them.
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While employers and insurance carriers delay and deny
compensation benefits, shifting the cost to the
taxpayers through depletion of the Medicare system,
is both offensive and repugnant. If the coalition
wants to ride the carousel of "it's not how long, but
how much," in doling out benefits, then they should
not blame CMS for delays and penalties, caused by the
coalition's own failure to report on a timely basis
if the first place.
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Complete Article With Links:
http://tinyurl.com/46w2keu
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Jon L. Gelman LLC |
Attorney at Law |
http://www.gelmans.com
1700 State Route 23 Suite 120 |
Wayne NJ 07470-7537
o. 973 696-7900 |
direct f. 973-807-1811 |
mailto:jon@xxxxxxxxxxx
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Blog-Workers Compensation :
http://workers-compensation.blogspot.com/
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Twitter :
http://www.twitter.com/jongelman
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Facebook Group :
http://tinyurl.com/yljckqh
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LinkedIn-Injured Workers Law & Advocacy Group :
http://tinyurl.com/2f7lsks
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Blog-Burn Pit Claims :
http://tinyurl.com/28apkym
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