Insurance News

Industry groups seek delay in Medicare payer rules

Posted on: February 9, 2010

WASHINGTON?Two property/casualty insurance industry groups and a self-insurance group asked the U.S. government Friday to delay implementation of mandatory Medicare secondary payer reporting requirements.

The requirements that are to go into effect April 1 are designed to ensure that Medicare remains the secondary payer when a Medicare beneficiary has medical expenses that fall under the primary responsibility of liability insurance?including self-insured, no-fault or workers compensation plans. Medicare also will be allowed to recover conditional payments that should have been covered by the primary insurance plan.

In a letter to Health and Human Services Secretary Kathleen Sebelius that was released Friday, the American Insurance Assn., the National Assn. of Mutual Insurance Cos. and the Self-Insurance Institute of America asked for a delay.

?Property/casualty insurers, as well as companies that self-insure, have been working diligently for the past two years to meet the new reporting requirements. Despite our best efforts and those of the senior decisionmakers within the Centers for Medicare and Medicaid Services, the agency has yet to demonstrate that the new reporting system will properly function,? the groups wrote.

?Yet, we are expected to begin reporting data using this system in just a matter of weeks. Even more critical, CMS has not yet provided final reporting parameters to those insurers and self-insurers subject to the new requirements. Since failure to comply with the reporting requirements as of April 1, 2010, will expose insurers and self-insureds to substantial financial penalties, we believe that a more realistic implementation date is not only appropriate but also imperative,? the groups said in the letter.

Copyright © 2010 Crain Communications, Inc.

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