October 3, 2005

CONTACT: Eric J. Oxfeld 202-637-3463

WASHINGTON, D.C., October 3, 2005 – In response to a lawsuit against the Social Security Administration (SSA), filed Friday by Health Advocates Inc., in a Florida federal district court, UWC urged the SSA to cease practices which harm workers’ compensation claimants, employers and insurers and increase Medicare costs.

“UWC urges the Social Security Administration to immediately desist from practices which put injured workers, their employers and workers’ compensation insurers in a Catch-22 situation,” said Eric Oxfeld, President of UWC – Strategic Services on Unemployment and Workers’ Compensation (UWC). “These practices also hinder workers’ compensation settlement procedures that save Medicare billions of dollars,” he continued.

“It is unfortunate that Health Advocates Inc. has been forced to file a lawsuit against the Social Security Administration to compel them to provide the information needed to reimburse Medicare for expenses that were not their responsibility, and more important, to avoid payment of future medical expenses that are not Medicare’s responsibility,” said June Simpson, President of Health Advocates Inc.

The lawsuit seeks to restore prompt access to information needed to comply with the Medicare Secondary Payer Act (MSPA). The MSPA requires that the parties to workers’ compensation settlements consider Medicare’s interests when the worker is Medicare-eligible or will become Medicare-eligible within 30 months. The Social Security Administration is the only source of information needed to verify Medicare eligibility in order to comply with the MSPA. But earlier this year SSA instituted new fees and adopted other procedures that unreasonably restrict access to needed information.

"The Social Security Procedure Operating Manual allows the release of this information,” Ms. Simpson noted, “but the Social Security Administration refuses to assist in making it available. The Manual states that large volume information requests should be submitted to their Central Office,” she added, “but that office is no longer operating, further inhibiting the ability to obtain critical beneficiary information."

“Medicare’s own MSPA procedures already casuse lengthy delays and substantially higher costs for the parties to workers’ compensation settlements and state workers’ compensation agencies,” Oxfeld pointed out. “By creating additional up front delays, Social Security’s procedures increase Medicare outlays, and they put workers, employers, insurers and attorneys at risk of double or treble damages for failing to protect Medicare under the MSPA,” he said. UWC leads a broad coalition seeking reform of the MSPA which protect the Medicare trust fund without harming workers, employers, insurers and states.

For a copy of the complaint, go to www.UWCstrategy.org/Issues/SSA_MSP_Complaint.pdf.

-UWC-