Recession Raises Profile of Medicare Verifications, Says Allsup
Transitional times carry risk
for insurers, who can better protect their operations with more
detailed information as July 1, 2009, MMSEA compliance deadline
approaches
Belleville, Ill. - April 8, 2009 - As reports
circulate about how the recession is affecting companies and
workers, it's crucial for insurers to comply with Medicare
Secondary Payer laws, according to Allsup. Allsup helps employers
coordinate their group health, disability and workers'
compensation benefit plans with Social Security and
Medicare.
With companies shedding jobs in the recessionary environment,
more workers are looking to resources such as workers' compensation
and disability insurance. This means that insurers can expect to
see an impact, according to Financial Week magazine, which recently
reported that WC claims expenses and frequency are likely to grow.
Insurance Networking News also reported on the impact of an
economic downturn, citing underwriters' concerns that plant
closings lead to a surge in workers' compensation claims.
A new Allsup study shows that Social Security Disability
Insurance (SSDI) claims have generally increased during the seven
recession periods over the past four decades. The 40-year analysis
includes the current recession, which began in December 2007,
according to National Bureau of Economic
Research data.
During 2008, the number of disabled workers applying for SSDI
benefits reached a record high of more than 2.3 million, according
to data from the Social Security
Administration (SSA). Disability applications overall
have reached 2.6 million.
As the economy contracts, people who have struggled with a
disability or work-related injury are forced to look for
alternatives they might not have otherwise considered, including
SSDI, which is why applications are increasing. One of the results
of these trends is an increasing number of people who are eligible
or covered under Medicare.
"For insurers, this means a changing environment that really
demands they become better informed about their compliance
requirements and liabilities," said Rob Sokol, director of
commercial sales at Allsup.
"Ultimately, they are responsible for the information that
will keep them in compliance with SCHIP stipulations and help them
avoid penalties that take effect July 1, 2009," Mr. Sokol
said.
This is the reporting deadline for non-group health plans
under the Medicare, Medicaid, and SCHIP Extension Act of 2007
(MMSEA), which further extends safeguards that ensure Medicare's
status as secondary payer.
Under Section 111 of MMSEA, group health plans and workers'
compensation, liability and no-fault claim providers must report
all cases to the Secretary of Health and Human Services (HHS) when
the insured claimant is Medicare entitled. The penalty for not
complying is $1,000 per day per claim. The effective date for
reporting was Jan. 1, 2009, for group health plans and July 1,
2009, for non-group health plans, including workers' compensation
handlers.
Allsup is offering its Medicare Verifications Service to
address this particular issue for providers. The service is part of
a suite of Medicare Secondary Payer compliance services that
include Medicare beneficiary notifications, conditional lien
services and Medicare Set-Aside services.
Medicare verifications, provided quickly and accurately by
Allsup, are the first and essential step toward meeting Medicare
Secondary Payer compliance, according to Mr. Sokol.
"Having this information in hand is one of the first steps
toward establishing and resolving other aspects of a claimant's
situation," he said. "Allsup has demonstrated for many providers
the value of these and related MSP services."
"These changing times mean that providers must increase their
vigilance for compliance, and Allsup is here to add more strength
to their efforts," he added.
For more information, contact Allsup at r.sokol@allsupinc.com.