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Rep. John Lewis's Medicare Employer Relief Act Signed into Law

April 21, 2015
Press Release

WASHINGTON--Today, President Barack Obama will sign into law H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015.  In an effort to streamline the Medicare reporting and payment process so that doctors can spend more time caring for patients, among other provisions, the bill repeals the outdated Sustainable Growth Rate (SGR) formula.  In place for 17 years, the SGR formula was criticized because it rewarded doctors for offering more care rather than better care.   H.R. 2 repeals the outdated SGR, and replaces it with a formula that helps free doctors from repetitive paperwork and procedures and incentivizes higher quality care.

As a part of the H.R. 2 fixes, the bill includes, in its entirety, a provision introduced by Rep. John Lewis last year as the Medicare Employer Relief Act (H.R. 943).  The Lewis bill eliminates a burdensome paper reporting process, required of employers by the federal government, with a more cost-effective and efficient electronic reporting system.

                "Since most Americans receive health insurance through their employers," said Rep. John Lewis,  "it is important to limit the burdens that employers must face to offer coverage. The Medicare Employer Relief Act offers the people a win-win solution.  It saves the federal government and American businesses time and money.   It eliminates costly redundancy, which saves taxpayers money, and lightens the reporting load of business and the federal government."

                The old statute required that Medicare be notified by the Internal Revenue Service (IRS), the Social Security Administration (SSA) and the Centers for Medicare and Medicaid (CMS) whenever a Medicare beneficiary is also covered by employer-provided group insurance.  This notification process, called the IRS, SSA, CMS Data Match program or ISCDM, saves taxpayers millions of dollars because it allows Medicare to serve as a secondary insurer rather than having the taxpayers foot the majority of the bill as a primary insurer.  However, once Medicare determines that a beneficiary receives employer-sponsored insurance, the current ISCDM statute required CMS to mail a paper questionnaire to the beneficiary’s employer that must be completed within 30 days under penalty of a fine. This paper-laden process requires a great deal of handling, which drives up the cost of the reporting.

                Though a change was made in 2007 which allowed primary insurance companies to report coverage to CMS and Medicare electronically, it still required CMS to generate a paper questionnaire that had to be filled out and returned by employers in 30 days.  The Medicare Employer Relief Act creates a simpler, more efficient electronic reporting process for employers and CMS to manage on-going data-matching needs. Obviously House and Senate leadership agreed because this provision  This solution will be made law today at a White House signing ceremony.