MARC Supporters;
We will meet this week in Washington DC with various groups to review our Legislative Agenda.
It is essential in our quest for a successful bid to change the law that we be able to take potential criticism now and make the necessary adjustments, instead of later when we are on the Hill.
We have invited all sides to meet with us including: the plaintiff and defense bar; insurance industry; TPA industry; Self Insureds; Professional Societies; Business Groups; and Medicare Advocacy Groups.
We feel strongly that there are no sides to the issues we look to reform and that our simple suggestions to Congress will go a long way to assist us in dealing with settlements that involve Medicare Beneficiaries.
In brief, our Legislative Agenda will work to accomplish the following:
- Ask CMS to provide a conditional payment demand before settlement, not after;
- Provide safe harbor alternatives that the parties to a settlement can take advantage of to satisfy conditional payments; should CMS not be able to provide its demand;
- Mandate reporting thresholds;
- Provide safe harbor for good faith effort to obtain SSN;
- Process to allow private parties to allocate settlement proceeds, short of proceeding to trial;
- Elimination of agent liability to CMS, but preserve private principal – agent claims for E&O;
- Establish clear limitations period;
- Soften penalties to be more in line with the settlement amount; and
- Provide for an appeal process, if the need arises to challenge CMS decisions.
We believe our Agenda is sound and the result of many lengthy discussions with various people in the industry that are experiencing the problems in the front line.
While it is our intent to push for our entire Agenda, we are keenly aware of the process and understand we may not get all of it.
However, we won’t know unless we try.
Of course, our ability to succeed will depend on our financial resources to press the issue with Congress.
This year provides a unique opportunity for us in that there are potentially several vehicles we could use to attach our proposed reforms to.
Therefore, the opportunity exists now, but it will take a lot of “lobby time” so our message is clearly heard and reacted to.
No doubt what we have to deal with is extremely “dense” and “granular” and we will have to get it down to a simple message that staffers can understand quickly.
This takes skill and we believe we have hired the best in Patton Boggs to get this done.
If you haven’t already contributed to the cause, I humbly ask that you do.
Your investment in our success will save you more than ten fold in the short run.
For those of you pioneers that have contributed, I wish to thank you.
We are here today because of your ability to be proactive risk managers and take on the issue before it materializes into the potential train wreck we all know that has left the station.
Although, MARC is pursuing its legislative agenda, we have not forgotten the myriad of issues that remain with MMSEA Reporting compliance.
In that regard, we will continue dialogue with CMS to clarify these open issues to bring further clarity.
Our efforts thus far have not gone unnoticed, in that recent alerts issued by the Agency are encouraging and bring us certain temporary compliance relief.
In that regard, I have attached two memos, that provide you with advice on the new timelines – both Katie Fox, from MedInsights and Mark Popolizio from NuQuest Bridgepoint are excellent resources on this topic.
However, please keep in mind that agencies don’t usually trump Federal Statutes and until a safe harbor is legislated we should continue to give the July 1, 2009 deadline a great deal of credence.
I would recommend putting processes in place to collect the data on all settlements, awards, judgments and other payments that occur after July 1, 2009.
You may be asked to supply it at a later date.
Further in that regard we have asked for additional meetings with CMS to clear up the reporting issues and will provide you with an update as the meetings occur.
Your financial support assists us in accomplishing these tasks and if you wish to help, please contact susan@murdockinc.com, our administrator for further information or visit us at www.marccoaliton.com.
I will update you after our legislative outline meeting.
Again, I appreciate the support out there and look forward to working with you to bring about change in the law.
Regards,
Roy A. Franco
Director Risk Management Strategies
