Pete Stark’s NGHP Study Initiated by the GAO

Medicare Set-Aside Blog on March 17, 2011 | Posted by

You may recall, on August 10, 2010, Pete Stark, the Chairman of the House Ways and Means Committee’s Subcommittee on Health, requested that the Government Accountability Office conduct a detailed examination of issues surrounding Medicare Secondary Payer (MSP) rules as they apply to non-group health plans (NGHP). At the time, two bills were sitting in his committee, H.R. 2641 and H.R. 4796, both seeking to address challenges placed on the insurance industry by the MSP. H.R. 2641 was the third evolution of a bill seeking to legislate changes to an unlegislated and unregulated voluntary program offered by CMS for only a particular subset of workers’ compensation settlements. It doesn’t take a GAO study to realize that you should probably legislate the program into official existence before you try to pose new legislation to make changes to it, yet three times they’ve tried. H.R. 4796 on the other hand posed changes to existing laws and gained an overwhelming amount of support in a short period of time therefore garnering the attention of the Committee. Unfortunately the elections occurred, co-sponsors disappeared, and interest in the matter appeared to be lost.


Clearly that was not the case, as we now have confirmed knowledge that the GAO has initiated the requested study and begun its investigation. A team of analysts faces the daunting task of trying to understand the issue, which an entire cottage industry developed around during the past decade, before it can even begin to quantify the data and answer the questions posed by the Chairman. While we don’t anticipate a speedy resolution, at least this is a sign of progress. In conjunction with the introduction of H.R. 1063 on Monday, we should feel as if perhaps we’re finally headed in the right direction.