Municipalities and Medicare

Is a municipality immune from conditional payment liability under the Medicare Secondary Payer Act, 42 U.S.C. §1395y(b)(8)? No. This answer may surprise claims managers for public entities, but the law provides no protection whatsoever for municipalities. Not even federal government agencies are exempt. The rationale is simple: Medicare needs to be made whole. Social Security and Medicare represent 14 percent of the U.S. budget, and Medicare alone has an unfunded liability of $89 trillion. The unfunded liability is the difference between the benefits that have been promised to current and future retirees and what will be collected in dedicated taxes and Medicare premiums. Insufficient taxes are being collected, benefit payments exceed those taxes, and the shortfall must come from somewhere. Medicare has in its crosshairs defendants, both private and public, who must take on this burden,  reimbursing Medicare for conditional payments made for an alleged accident

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Featured News

  • MARC Coalition Sends Letter to CMS Regarding MSA Reporting Concerns

    January 23, 2025 (Washington, DC) – The MARC Coalition today sent a letter to the Center for Medicare and Medicaid Services urging the Agency to reform its proposal to require entities settling claims with Medicare beneficiaries to report any “Medicare Set Aside” or MSA arrangements as part of the Section 111 process. The letter requested clarification […]

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  • MARC Coalition Hosts Webinar to Discuss Section 111 Civil Money Penalties

    October 28, 2024 (Washington, DC) – The MARC Coalition today hosted a webinar about Section 111 Civil Money Penalties at 2:00pm ET. David Farber, Partner at King and Spalding, and Susan Lin, Divisional AVP – Corporate Claims, Medicare Strategy at Great American Insurance Group, were the presenters. The hour-long webinar featured a presentation to discuss the […]

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  • MARC Celebrates Bicameral and Bipartisan Introduction of the RAMP Act in Congress

    Washington, DC (May 17, 2023) Today the Medicare Advocacy Recovery Coalition (MARC) applauded Senators Tim Scott (R-SC) and Maggie Hassan (D-NH) and Representatives Brad Schneider (D-IL) and Gus Bilirakis (R-FL) for introducing the Repair Abuses of MSP Payments Act (RAMP Act, S.1607/H.R.3388) in the U.S. Senate and the U.S. House of Representatives, respectively.

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