The health care delivery system in Ohio is broken. With skyrocketing costs well above inflation, too many Ohio families and businesses are struggling to pay for health care, and over a million Ohioans have no insurance coverage at all. When uninsured Ohioans do access the system, it is often through the emergency room, bypassing the primary care they need and shifting the substantial costs to others.
Unfortunately, the health care law rammed through Congress in 2010 does not address the basic cost and access challenges Ohio faces. In fact, the law leads to higher health care costs, large tax increases, and many Ohioans losing the coverage of their choice. It also limits choices on doctors and medical treatment options.
That`s why I believe we ought to repeal the health care law that passed in 2010, start over, and replace it with proposals that actually reduce costs and increase competition. Such proposals include eliminating the barriers to allow small businesses, associations, and other organizations to band together and offer health insurance at lower costs, increasing competition by allowing companies to sell health insurance across the state lines, and reducing the mounting cost of defensive medicine by enacting sensible legal reforms and better health information to stop the frivolous lawsuits.
Senator Ron Wyden and I led a bipartisan effort to make the Medicare Secondary Payer (MSP) Program more efficient and cost effective to taxpayers. The Strengthening Medicare and Repaying Taxpayers (SMART) Act speeds up the rate by which Medicare and its beneficiaries are reimbursed for costs that should be borne by another party. With Washington’s sky high debt and deficit, we need to do everything we can to ensure that entitlement programs such as Medicare are cost effective and working for the very people they were designed to help.
Under the MSP program, if a Medicare beneficiary is injured by a third party and a settlement is pursued as a result of that injury, the third party is responsible for paying for the individual’s medical expenses. If Medicare, now the “secondary payer,” pays any of the costs associated with the injury, it is entitled to reimbursement.
Several problems existed with the reimbursement process under this scenario before passage of the SMART Act. Prior to passage of the SMART Act, Medicare did not have a way to disclose the MSP amount before settlement, and this created unnecessary uncertainty that made it hard to settle cases. Second, there were times when Medicare spent more money pursuing an MSP payment than they actually ended up receiving in payment. MSP reporting requirements also required beneficiaries to submit sensitive personal information to the settlement company, which led to privacy concerns. Finally, there was no clear statute of limitations on all MSP claims.
The SMART Act addressed these issues by creating a process that allows CMS to disclose the MSP amount before settlement so it can be factored into the settlement; requiring Medicare to no longer pursue MSP claims that do not cover their own expenses; directing Medicare to establish an alternative method of identifying individuals so that they don’t have to provide sensitive personal information; and setting a three-year statute of limitations for most claims.Read more about the SMART Act here.