Medicare Secondary Payer Law and Market Corner Updates in Risk Financing
Risk Financing Perspectives for this Risk
Financing release provides updates to a discussion on workers
compensation claims costs imposed by the Medicare Secondary Payer
law and the Medicare, Medicaid, and SCHIP Extension Act (MMSEA) authored by
John D'Alusio of D'Alusio Insurance Services in Bradenton, Florida.
Under the Omnibus Budget Reconciliation Act of 1981 and Title 42 of the Social
Security Act, Congress took steps to give Medicare some degree of fiscal
protection by affording it secondary payer protection. In 2007, the MMSEA was
signed to add another layer of fiscal protection for the Medicare program. The
resulting cost implications for self-insureds, insurance companies, and
insureds with high retentions or deductibles are described in this discussion.
It summarizes the requirements and explains the responsibilities of insureds
and insurers for Medicare Set-Asides, loss reporting, and claims payments. The
discussion also addresses a recent proposal by the Centers for Medicare and
Medicaid Services to increase the penalties that may be imposed on entities
failing to comply with reporting requirements.
"Market
Corner" provides quarterly updates on current property and casualty
insurance market conditions. Aside from workers compensation, renewals of most
major lines of coverage across a broad range of industries have been more
difficult than at any time over the last decade. Insurance buyers are often
struggling to find adequate insurance capacity for their liability and property
risks. The direction of the market over the next several quarters will depend
in part on the impacts from potential future waves of COVID-19 infections.