Medicare Secondary Payer Activities Expected to Accelerate This Fall

Share Article

Allsup highlights opportunity to complete settlements before year-end.

News Image
“Developments happening this fall could provide us with the flagship regulatory guidance from the CMS that shape the MSP industry going forward.” — Rob Sokol of Allsup

The Centers for Medicare & Medicaid Services (CMS) anticipates several steps related to the Medicare IVIG Access and Strengthening Medicare and Repaying Taxpayers Act of 2012 (SMART Act) and other regulatory changes this fall, signaling the opportunity for employers, and workers’ compensation and liability insurance carriers to complete settlements, according to Allsup, a nationwide provider of Medicare Secondary Payer (MSP) compliance services for employers and insurance carriers.

Reported activities related to the SMART Act include:

  • An advanced notice of proposed rulemaking on civil monetary penalties, regarding what penalties will and will not be imposed under the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA).
  • Plans to implement a Web-based portal under the SMART Act that provides beneficiaries and other authorized representatives the ability to access beneficiary-specific Medicare Secondary Payer information. According to the CMS, this information includes liability insurance (including self-insurance), workers’ compensation, and no-fault insurance settlements, judgments, awards or other payments.

Under a separate regulatory initiative, the CMS also has provided notification of proposed rules that beneficiaries or their representatives may use to protect Medicare’s interest under MSP for a single set of Medicare Set-aside Arrangement (MSA) procedures involving automobile and liability insurance (including self-insurance), no-fault insurance, and workers’ compensation cases.

“Developments happening this fall could provide us with the flagship regulatory guidance from the CMS that shape the MSP industry going forward,” said Rob Sokol, director of Medicare Secondary Payer Compliance at Allsup. “It’s a critical time in the roll-out of SMART Act policy, but also a critical time as many employers and carriers work to complete settlements for 2013.”

Aaron Frederickson, Allsup director of MSPC, agreed. “The SMART Act signals a great opportunity for the CMS to clarify not only issues concerning Medicare conditional payment resolution, but guidance in the form of regulations related to Medicare Set-asides under the voluntary submission program.”

In addition to assisting carriers with conditional payment resolution, Allsup offers MSA services to the workers’ compensation and liability industries to assist in compliance with Medicare and Medicare Secondary Payer guidelines.

Allsup audits claims, analyzes future medical expenses, provides comprehensive tracking reports, quantifies allocation amounts, prepares written proposals, resolves Medicare conditional payments, establishes an ongoing management process for clients, and coordinates compliance with both MSP and SCHIP regulations. Allsup’s most recent Client Satisfaction Survey found 92 percent of client supervisors and examiners had or would recommend Allsup to a colleague.

Contact Allsup at (866) 477-7005 or msaservices(at)allsupinc(dot)com for more detailed information about how to incorporate Allsup’s MSP compliance services into an existing claims management process.

To submit an MSA referral, email msaintake(at)allsupinc(dot)com or visit

Allsup is a nationwide provider of Social Security disability, veterans disability appeal, Medicare and Medicare Secondary Payer compliance services for individuals, employers and insurance carriers. Allsup professionals deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. Founded in 1984, the company is based in Belleville, Ill., near St. Louis. Visit

The information provided is not intended as a substitute for legal or other professional services. Legal or other expert assistance should be sought before making any decision that may affect your situation.

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Rebecca Ray
+1 (800) 854-1418 65065
Email >
Visit website