The GAO Report on the MSP Program – A Closer Look at the Players

The March 2012 report from the U.S. Government Accountability Office (GAO) is packed with information, and provides a fascinating look at the Medicare Secondary Payer (MSP) program.   There are so many issues addressed in this GAO report that I thought I would address them in separate blogs.  In this blog, I will discuss the background of the report, how it came about and who the parties are.

MARC Coalition – Formed in 2008 to advocate improvements to the Medicare Secondary Payer (MSP) program on behalf of beneficiaries and affected companies, the Medicare Advocacy Recovery Coalition (MARC) is, without a doubt, the main driving force behind this GAO study.  They have worked tirelessly on Capital Hill to bring about reform of the MSP program.  Their main accomplishment has been to introduce H.R. 1063, the Strengthening Medicare and Repaying Taxpayers Act of 2011 (SMART ACT) and it’s Senate counterpart S. 1718.

Congressman Pete Stark (D-CA) – On August 10, 2010, Congressman Pete Stark, wrote a letter, in his capacity as Chairman of the Health Subcomittee of Ways and Means committee, to the GAO requesting that a study be done.  Congressman Stark’s letter was the catalyst that prompted this study.  The March 9, 2012 GAO report is specifically addressed to “The Honorable Fortney Pete Stark, Ranking Member, Committee on Health, Committee on Ways and Means, House of Representatives.

The GAO – The Government Accountability Office (GAO) is the audit, evaluation and investigation arm of Congress.  It exists to support Congress and to help improve the performance and accountability of the federal government for the American people.   The GAO examines the use of public funds, evaluates federal programs, and provides analysis and other assistance to Congress.

CMS – The Centers for Medicare and Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children’s Health Insurance Program (SCHIP), and health insurance portability standards.

So, this GAO study was in response to a letter from Congressman Pete Stark asking the GAO to examine CMS’s MSP program and processes.  Although the MARC coalition and H.R. 1063 was the primary driving force behind this, Medivest also played a significant role because of meetings it had with key Congressional representatives and staff.  In those meetings Medivest pointed out the practical necessity of apportionment in liability cases, the benefits of MSA review thresholds, and the benefits of professional administration.


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