On Friday, December 21, 2012, in the midst of the upcoming holidays and the discussions on how to avoid the Fiscal Cliff, Congress passed H.R. 1845 (2012) entitled The Medicare IVIG Access and Strengthening Medicare and Repaying Taxpayers Act of 2012. Of particular interest is Title II – Strengthening Medicare Secondary Payments. Title II amends Section 1862(b)(2)(B) of the Social Security Act (codified at 42 U.S.C. 1395y(b)(2)(B)) which permits the Secretary of Health and Human Services (the Secretary) to make conditional payments from the Medicare and Medicaid funds until such time as other payments from e.g. awards, judgments, or settlements, are available to reimburse the funds.
Title II requires the Secretary to establish a website which will have two basic functions. First, the website will allow claimants to notify the Secretary about the expected dates of awards, judgments, and settlements that will be used to reimburse the Medicare and Medicaid funds. Second, this website will also provide information to claimants on reimbursements owed and any reimbursements paid.
In addition to establishing the website, Title II also instructs the Secretary to establish processes and procedures for claimants who dispute the amount the Secretary is seeking in reimbursement. Among the provisions, claimants, when filing a discrepancy, are not only required to provide documentation of the discrepancy but are also required to provide a proposal for resolving the discrepancy. The Secretary then has 11 business days after receiving the documentation to determine whether to amend the reimbursement statement by adding or deleting claims. If the secretary fails to make this determination, the claimant’s proposal for resolution is automatically accepted. Finally, the last section of Title II adds a statute of limitation provision that requires that any action brought to recover payment must be brought within 3 years from the “receipt of notice of a settlement, judgment, award, or other payment. . . .” H.R. 1845 Sec. 205.
Govtrack.us reports that Congress passed this law by an overwhelming majority in the House of Representatives (401-3) and by Unanimous Consent in the Senate. As ofnoon on Monday,December 31, 2012, H.R. 1845 has not been signed into law but has been sent to the President for his signature.