The MARC Monitor: October 2017

Welcome to The MARC Monitor, your monthly update on federal secondary payer policy. As you may know, the Medicare Advocacy Recovery Coalition (MARC) is a national coalition advocating for the improvement of the Medicare and Medicaid Secondary Payer (MSP) programs. Each month, we’ll be bringing to your inbox the latest news, activities, and alerts on the issues that are driving the day in Washington on MSP. 

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Despite Washington reaching a fever pitch last month over “repeal and replace,” three new Members of Congress signed on as cosponsors to our signature legislative initiative, the Secondary Payer Advancement, Rationalization and Clarification (SPARC) Act in recent weeks. As outlined last month in an pair of articles published in Law360 and CLM Magazine, the SPARC Act offers important reforms to Medicare’s secondary payer laws pertaining to Part D, including requiring the Centers for Medicare and Medicaid Service (CMS) to provide Part D Plans with timely access to settlement data.

The SPARC Act currently has six total sponsors: Reps. Tim Murphy (R-PA) and Rep. Ron Kind (D-WI), who introduced the bill; Rep. Pat Meehan (R-PA), a member of the Ways and Means Committee; Rep. David Rouzer (R-NC), Rep. Hal Rogers (R-TN) and Rep. Steve Chabot (R-OH). While we’ve continued to see momentum building for the SPARC Act, the is more that can be done. We’ve generated hundreds of comments to Members of Congress through our Action Center, and encourage stakeholders to continue to voice their support for the bill.

An update on all the issues we’re following this month is included below. For more info, follow us on social media and visit us at

Until next month,

The MARC Team

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MARC continues working to build momentum on Capitol Hill for the SPARC Act — our top legislative priority in the 115th Congress. To encourage Members of Congress to co-sponsor the legislation, it’s important for them to hear from their constituents. That’s why MARC is working on a coordinated grassroots letter campaign with the goal of producing hundreds of letters to Capitol Hill in support of the SPARC Act.

To make it easy for you to encourage your friends, colleagues, and professional network to submit letters, we have developed a draft email below which we hope you will send to as many individuals as possible. The email provides a brief overview of the SPARC Act, and sends people directly to the MARC Advocacy Center where they can quickly submit a letter of support to their Congressman.

Tell Congress: Fix the Medicare Secondary Payer System

Please take two minutes to click on the MARC Advocacy Center and send an email to your Members of Congress urging them to cosponsor the Secondary Payer Advancement, Rationalization and Clarification (SPARC) Act.

When a Medicare beneficiary is injured and another entity is required to pay for their health care expenses – such as in a workers compensation claim – Congress has long recognized that Medicare’s responsibility to pay is “secondary.” This well-established MSP policy is designed to ensure that the Medicare program and Part D prescription drug plans (PDPs) do not waste taxpayer dollars by reimbursing healthcare expenses for which another entity is legally responsible. Unfortunately, the current Medicare Secondary Payer (MSP) policy is confusing, creating problems and inefficiencies for beneficiaries, settling parties and taxpayers alike.

The SPARC Act is not associated with the American Health Care Act. Rather, the bill is a bipartisan measure to improve the MSP program in Medicare Part D. [ORGANIZATION] has been working with the Medicare Advocacy Recovery Coalition (MARC) on this bill to achieve a more efficient solution for beneficiaries, taxpayers, and employers. The SPARC Act will significantly improve the efficiency of the current system, providing a clear framework for communication among everyone involved. This infographic provides a helpful overview of how it works.

To build momentum for our bill despite the chaos in Washington, we need your help! It takes just two minutes to submit a letter to your Member of Congress encouraging them to co-sponsor this important legislation. By writing a letter, you will join hundreds of other individuals who are reaching out to Congress to encourage support for this bill.

If you haven’t already viewed our comment portal, please CLICK HERE to quickly submit your letter. Your voice matters! 

Tell Us Your Story

As part of our efforts to generate stories from individuals who have faced real-world complications or disruptions in care related to federal MSP laws, MARC has developed a new webpage where individuals can share their story. The information submitted will remain confidential, as users are not required to include their name or email address with their submission — only a brief comment is required.

Among the questions prompted to site visitors:

  • Have you struggled to have Medicare claims paid after settling a workers compensation case?
  • Did you get reimbursed after an accident, then struggle with Medicare on a future claim? 
  • Have you been denied coverage by Medicare after being reimbursed from an automobile injury?

We encourage you to invite individuals to fill out the form by visiting:

Law360: Making Good Better – How to Improve Medicare Part D

In an article published last month in Law360, MARC Counsel David Farber outlines the issues with the current Medicare Secondary Payer (MSP) Program as it pertains to Medicare Part D. “While Medicare struggles to run [the MSP] program for the Part A and Part B programs, secondary payer in the Part D program does not work at all,” he writes. “Why has Part D secondary payer failed? Because unlike Parts A and B, parties settling a disputed case with a Medicare beneficiary have no ability to identify which Part D plan that beneficiary uses, much less if the Part D Plan paid for any drugs related to the accident or injury.”

Mr. Farber continues, “Similarly, PDPs have no ability to identify settling parties from which they can recover. This uncertainty puts at risk beneficiaries’ ability to settle legitimate claims in the first instance, and can often tie up recoveries in escrow for months or years. And everyone is at risk of litigation…. Fortunately Reps. Murphy and Kind, the lead authors on the SMART Act of 2013, which overhauled and greatly improved the Part A/B secondary payer system, have taken the initiative to develop a functional program for Part D.” 

CLM Magazine: A SPARC of Hope

In an article published in CLM Magazine, MARC members Greg McKenna and Heather Sanderson discuss how the SPARC Act (H.R. 1122) could bring needed changes to improve the Medicare Secondary Payer (MSP) law. “When Congress created the Part D program in 2003 as part of the Medicare Modernization Act (MMA), it failed to address secondary payer issues beyond simply stating that Part D Prescription Drug Plans’ secondary payer rights were ‘in the same manner’ as Medicare Advantage Plans,” they wrote, adding that “this process is inefficient and costly to enforce.”

The authors go on to explain that the SPARC Act “would make clear who is responsible for prescription drug costs and when they must be reimbursed. It would also clarify when that responsibility begins, how a prescription drug plan (PDP) can recover past payments, and when and how CMS must share data to help facilitate the secondary payer recovery process.” McKenna and Sanderson conclude that the SPARC Act “would provide commonsense reforms to improve healthcare outcomes for Medicare Part D beneficiaries, insurance carriers, and PDPs.”

Featured News

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