Urge Your Congressional Leaders to Co-Sponsor the SPARC Act – H.R. 6120 Today!

The SPARC Act produces wins for Medicare beneficiaries, the Medicare Trust Fund and businesses resolving claims.

The Secondary Payer Advancement, Rationalization, and Clarification (SPARC) Act (H.R. 6120) was introduced into the U.S. House of Representatives on September 22, 2016 by   Congressmen Tim Murphy (R-PA) and Ron Kind (D-WI), who are leading a bipartisan effort to improve the Medicare Secondary Payer (MSP) Program in the Medicare Prescription Drug benefit. 

The SPARC Act will significantly improve the efficiency of the current Medicare Secondary Payer (MSP) system and speed repayment of amounts owed from Medicare beneficiary claims directly to the Medicare Part D Prescription Drug Plans.

The SPARC Act creates a clear and functional MSP system for Part D drugs, benefitting Medicare beneficiaries and Part D Drug Plans. Today, Medicare beneficiaries and third parties are unable to settle claims, because they are unable to determine the amount of money that needs to be repaid to Part D Plans.  Ironically, these same Plans cannot be timely reimbursed for medications dispensed to beneficiaries, wasting taxpayer, business, and judicial resources alike.  

The SPARC Act – will create a more efficient and effective system for all involved by:

  • Permitting Part D Drug Plans to secure a clear recovery rights from settling parties to recover past payments for prescription drugs covered by a later settlement, saving PDPs and the government significant funds in allowing greater recoveries faster;   
  • Increasing fairness to beneficiaries by reducing recoveries for procurement costs, consistent with other federal laws, and aligning incentives so that Plans only pursue those claims where a recovery will exceed the cost of collection;   
  • Restoring sense to the program by allowing plans to waive secondary payer provisions if costs of recovery exceed the amount to be recovered;
  • Requires CMS within 15 days of receipt to pass settlement information to Plans to timely coordinate benefits, and requires drug plans to instruct pharmacies to bill entities that have accepted an ongoing responsibility to pay for medical benefits, thus avoiding plans paying for drugs when others are responsible; and
  • Leveraging the SMART Act expedited repayment procedures, involved drug plans in the expedited repayment process, bringing finality to all involved in settling claims with beneficiaries.


Urge your Congressional Leaders to Co-Sponsor the SPARC Act – H.R. 6120 Today!

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