On August 2, 2019, Representative Mike Thompson (D-CA) and Representative George Holding (R-NC) introduced the COMP Act (HR 4161) to clarify the application of Medicare Secondary Payer provisions to Workers’ Compensation.

The bill has broad based support from injured worker representatives and workers’ compensation payers seeking to clarify the application of MSP to Workers’ Compensation settlements. HR 4161 would improve the current process by:

  • Creating certainty for calculating the amounts to be included in set-asides;
  • Establishing criteria for Set-aside arrangements to assure that Medicare’s interest in future medical expense is covered;
  • Providing the ability to establish fair guidelines for set asides in compromise settlement cases;
  • Providing a right of appeal for parties to settlements who choose to submit set-aside arrangements to CMS for review;
  • Providing an optional direct payment of set-aside amounts to Medicare.

HR 4161 will provide certainty and allow the settlement process to move forward while eliminating millions of dollars in unnecessary administrative costs.

The direct payment option enables individuals, with agreement of all parties to the settlement, to choose to pay the total set-aside amount directly to CMS. This option allows the injured worker and CMS to avoid the ongoing burden of tracking medical expenses attributed to the workers’ compensation injury to be paid from set-aside funds.

The proposal has the support of attorneys representing injured workers and workers’ compensation payers.

>> Download Summary of HR 4161