U.S. Rep. Tim Murphy (R-PA) introduced bipartisan legislation last week that would clarify and simplify the Medicare Secondary Payer (MSP) provision of the Medicare Prescription Drug (Part D) program.
The Secondary Payer Advancement, Rationalization and Clarification (SPARC) Act marks a continuation of bipartisan efforts led by Murphy and U.S. Rep. Ron Kind (D-WI) to improve and bring clarity to MSP.
In 2003, Congress established a secondary payer requirement under the Medicare Modernization Act but didn’t outline a clear path to implement it. That led to Part D prescription drug plan beneficiaries having difficulty recovering funds and settlements spanning years.
“The SPARC Act will increase fairness to beneficiaries, create greater certainty for all settling parties and avoid wasteful spending by allowing plans to waive secondary payer provisions if costs of recovery exceed the amount to be recovered,” Murphy said.
In 2012, Murphy and Kind successfully led the Strengthening Medicare and Repaying Taxpayer (SMART) Act, which streamlined the process for settling claims and releasing funds to Medicare beneficiaries.
“Since it became law in 2013, the SMART Act has drastically improved the MSP to provide greater fairness for beneficiaries who were trapped in a confusing maze of bureaucracy,” Murphy said. “The SPARC Act, built to augment the SMART Act, will clarify, streamline and bring cost-saving efficiency to the relationships between Medicare beneficiaries, entities settling claims with beneficiaries and the Part D Plans providing medications to beneficiaries.”
Kind said SPARC would bring clarity and certainty to seniors when it comes to paying for prescription drugs.
“This bill gives beneficiaries and Part D Plan holders much needed clear and concise rules for covering necessary prescriptions,” Kind said. “The SPARC Act expands on the ‘win-win-win’ that we brought to the Medicare Secondary Payer laws through the SMART Act four years ago.”