BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AJR 42
                                                                  Page  1


          ASSEMBLY THIRD READING
          AJR 42 (Solorio)
          As Introduced May 28, 2010
          Majority vote 

           HEALTH              18-0                                        
           
           -------------------------------- 
          |Ayes:|Monning, Fletcher,        |
          |     |Ammiano, Carter, Conway,  |
          |     |De La Torre, De Leon,     |
          |     |Eng, Gaines, Hayashi,     |
          |     |Hernandez, Jones, Bonnie  |
          |     |Lowenthal, V. Manuel      |
          |     |Perez, Salas, Smyth,      |
          |     |Audra Strickland,         |
          |     |Nestande                  |
          |     |                          |
           -------------------------------- 
           SUMMARY  :  Makes specified legislative findings and declarations  
          regarding H.R. 4796, the Medicare Secondary Payer Enhancement  
          Act of 2010 (MSPEA) and requests that the Congress and the  
          President of the United States enact MSPEA.  Specifically, this  
          resolution  :  

          1)Makes the following declarations regarding the federal  
            Medicare Secondary Payer (MSP) law:

             a)   It is an important law that is designed to protect the  
               Medicare Trust Fund and ensure that Medicare pays only for  
               medical expenses for which it is responsible;

             b)   With respect to claims involving individuals who are  
               eligible for the Medicare Program, it has caused  
               considerable delay and unfairness in settlement of claims;  
               and,

             c)   The delays in settlement of claims and uncertainty of  
               the scope of responsibility for Medicare has increased  
               settlement costs.

          2)States that the MSPEA has received bipartisan support and is  
            supported by a broad coalition.  









                                                                  AJR 42
                                                                  Page  2


          3)Respectfully requests that the Congress and the President of  
            the United States enact MSPEA.  

           FISCAL EFFECT  :  None

           COMMENTS  :  The MSPEA was introduced on March 9, 2010, to address  
          inefficiencies and problems in the MSP system that make it  
          nearly impossible for many parties to determine how much is owed  
          to Medicare.  There is currently no appeal process for an entity  
          with MSP responsibility that disagrees with Medicare's  
          calculation, which results in claims not being resolved in a  
          timely manner.  In an effort to enhance efficiencies of the  
          process, the MSPEA would revise the flow of information so  
          parties know how much is owed to Medicare before settling,  
          create a right of appeal for parties who disagree with MSP  
          calculation and establish a reasonable statute of limitations,  
          adopt a sensible MSP recovery threshold so that Medicare does  
          not spend more taxpayer money pursuing a claim than the claim is  
          actually worth, and removes the requirement that Medicare  
          beneficiaries disclose sensitive personal ID numbers.


           Analysis Prepared by  :    Martin Radosevich / HEALTH / (916)  
          319-2097                                               FN:  
          0004944