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SMART Act Signed into Law

The new law streamlines the process for Medicare recipients, insurers and TPAs to settle claims.

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Insurers, third-party administrators, attorneys and Medicare recipients will find it much easier to settle claims now that the SMART Act has been signed into law. Before the Strengthening Medicare and Repaying Taxpayers Act became law on Jan. 10, "it was difficult or almost impossible for the parties to estimate what their exposure would be toward the final settlement if there were outstanding conditional payments that would have to be repaid to Medicare," said Michelle A. Allan, an attorney with the Medicare Compliance Group at Burns White in Pittsburgh. "The time delays made it terribly burdensome for the parties," she said. "You wanted to settle your claim, but you didn't know what your final amount to reimburse Medicare was until the final settlement occurred."

The new law provides a password-protected website that makes it possible to find the amount Medicare is seeking for reimbursement while settlement discussions are ongoing. Before, final settlement could occur and leave some parties "pretty blindsided by the amount," Allan said. The new law also sets a three-year statute of limitations for the federal government to seek reimbursement, said Christina Horton Duty, who also is with the Medicare Compliance Group at Burns White.The act also changes civil monetary penalties for noncompliance from mandatory to discretionary.

--By Anne Freedman

March 1, 2013

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