On Friday, February 27, the Centers for Medicare and Medicaid Services published its final rule implementing provisions of the Strengthening Medicare and Repaying Taxpayers (SMART) Act of 2012 regarding the appeals process for liability insurance (including self-insurance), no-fault insurance, and workers’ compensation laws or plans when Medicare pursues a Medicare Secondary Payer (MSP) recovery claim directly from those entities (here).
The rule, which becomes effective April 28, 2015, provides the following:
This is a significant step by CMS in implementing the provisions of the SMART Act and ECS will monitor CMS practices under this rule to ensure applicable plans receive their proper rights of appeal.
Further commentary on the final rule can be found here.
ExamWorks Compliance Solutions will continue to keep you apprised of updates to the Final Rule implementation process as well as all relevant Medicare Secondary Payer compliance developments.