SPARC Act – H.R. 6120 Introduced!

Congressman Tim Murphy (R-PA) and Congressman Ron Kind (D-WI) introduced bipartisan legislation to improve the Medicare Secondary Payer (MSP) statute and clarify how it applies to the Medicare Prescription Drug (Part D) program. H.R. 6120, the Secondary Payer Advancement, Rationalization, and Clarification (SPARC) Act, will replace ambiguous and uncertain Part D MSP requirements with clear and sensible rules to allow Part D Prescription Drug Plans to recover greater amounts of prescription drug costs from primary payers faster.

“The SPARC Act will continue to aid efforts to fix the MSP statute by focusing on the Medicare Part D Program,” said Congressman Murphy, who has been working for years to bring more efficiency and common sense rules to the MSP statute. In 2012, Murphy and Kind worked to successfully move H.R. 1845, the Strengthening Medicare and Repaying Taxpayer (SMART) Act, through Congress. The SMART Act also works to improve the MSP statute by streamlining the process of settling claims and providing funds to Medicare beneficiaries, among other advancements.

“Since it became law in January 2013, the SMART Act has drastically improved the MSP to ensure fairness for senior beneficiaries who were trapped in a confusing maze of bureaucracy,” continued Murphy. “This new legislation, in addition to the SMART Act, will work to ensure that Medicare beneficiaries, entities settling claims with beneficiaries, and the Part D Plans providing medications to beneficiaries can all come out ahead.”

“Seniors across the country deserve clarity and certainty, especially as it applies to payment for prescription drugs. This legislation will ensure that beneficiaries and Part D Plans have clear and concise rules for covering necessary prescription drugs. The SPARC Act expands on the “win-win-win” that we brought to the MSP laws through the SMART Act four years ago,” said Congressman Kind.

In 2003, when passing the Medicare Modernization Act, Congress was uncertain how to address secondary payer issues and created a vague requirement that did not appropriately address the realities of a prescription drug benefit. As a result, although the Part D program over the past decade has been very successful, the Part D Secondary Payer program has largely failed, with Part D Presription Drug Plans rarely recovering amounts owed to them, and beneficiaries and private entities settling claims left with years of uncertainty. The SPARC Act will remedy this problem by bringing sensible reform to the law, benefitting Medicare beneficiaries, the Part D Plans, and those entities settling cases with them.

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