Monthly Archives: September, 2012

The SMART Act Passes Energy and Commerce Health Subcommittee on 9-11

The SMART Act is a piece of legislation designed to make the Medicare Secondary Payer Act more user friendly.  It addresses current issues with the conditional payment recovery process.  The legislation has been sitting in the House Energy & Commerce Health Subcommittee for quite some time.  On 9/11/12, it passed the committee with markup that has changed some of the key provisions. 

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From Roger Baron: SDNY holds SPD provision not enforceable under Cigna v Amara

Reprinted with permission from Roger Baron

In Durham v. Prudential Insurance, 2012 WL 3893604 (S.D.N.Y. Aug. 28, 2012), the Court was requested by the ERISA Insurer to uphold the “discretionary clause”  of the SPD, but the plan document did not contain a “discretionary clause.”  This Court applied the Supreme Court’s ruling in Cigna v. Amara and held that “the SPD cannot confer discretion.

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