The Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA)has created new reporting obligations for businesses. The federalgovernment, through its increasing enforcement of the MedicareSecondary Payer Act (MSPA), has demonstrated an objective to avoidor recover all Medicare costs for which a privately insured orself-insured program can be held responsible.

The current implementation of MMSEA will likely enable even morerigorous enforcement, which will further enhance the need foraccurate claim processing and resolution. This is partially becausenon-compliance -- in the form of inaccurate or inflated payments --will result in hefty fines or penalties.

To address Medicare compliance as a core claim managementresponsibility, Sedgwick Claims Management Services, Inc. hasdeveloped an in-house, integrated option for its clients. Availableto workers' compensation and liability claim management clients,Sedgwick's CMS Medicare solution includes Medicare set-asidedetermination, Medicare conditional payment ("lien") negotiationand resolution, and related consulting services.