FOR IMMEDIATE RELEASE
Contact: Nathan Heggem
Senior Communications and
June 22, 2011
Medicare Rights Center Federal Policy Director Ilene Stein Testifies at
House Energy and Commerce Committee Hearing on the
Medicare Secondary Payer Policy
-- Testimony Calls for Greater Consumer Protections --
Washington, DC – Ilene Stein, federal policy director at the Medicare Rights Center, is presenting testimony today at the House Energy and Commerce Committee’s hearing on the Medicare Secondary Payer policy. The policy aims to ensure that Medicare does not pay for medical services that are, or should be, covered by another payer or insurer. Medicare can be a secondary payer, for example, if a person with Medicare is involved in an accident at a place of business and that business is liable for medical and other costs caused by the accident.
In Medicare Rights’ testimony, Ms. Stein advocates for better communication of consumers’ rights and highlights the problems that occur when Medicare attempts to recoup costs from beneficiaries. Ms. Stein describes situations in which beneficiaries who are not aware of the Medicare Secondary Payer policy have settled accident cases, only to later discover that they owe a sizeable portion of the settlement to Medicare. In some cases, Medicare recoups almost the full amount of a settlement, and frequently this demand comes years after the settlement was received and spent. This can create a precarious financial situation for beneficiaries.
“We know that the misadministration of the Medicare Secondary Payer program adversely affects people with Medicare,” said Ms. Stein. “We hear their stories on our helpline, and they inform our policy decisions every step of the way. Medicare should have the right to collect payment for services covered by other insurers, but not at the expense of patients’ physical and financial well-being.”
The testimony outlines the major problems with the current system, including:
- Untimely collection of Medicare’s share of settlements;
- Medicare Secondary Payer Recovery Contractor (MSPRC) calculation errors;
- Difficulty obtaining information from MSPRC about secondary payer cases;
- Difficulty resolving cases with MSPRC;
- Problems with notices, appeals and the hardship waiver process.
The testimony presents several recommendations as solutions to these problems, including:
- Medicare’s collection practices must ensure timely notice about the amount owed to Medicare, and timely recovery;
- Medicare should provide the insurer and the consumer with an estimate of conditional payments made for treatment related to the injury, as well as an estimate of future treatment costs;
- CMS and its contractor should develop a better process for separating claims that are and are not related to an accident;
- The hardship waiver process should be made more transparent and less burdensome on consumers.
The Energy and Commerce Committee called the hearing to analyze the current Medicare Secondary Payer system and its effects on consumers, insurers, businesses, taxpayers and the Medicare trust fund.
Read the testimony.
- end -
Follow us on Facebook and Twitter:
Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.
520 Eighth Avenue, North Wing, 3rd Floor ∙ New York, New York 10018
1224 M Street, NW, Suite 100 ∙ Washington, D. C. 20005 ∙ www.medicarerights.org