Tuesday, February 3, 2009

Negotiating a Medicare Lien

Posted by Mary Skinner

I have a settled Personal Injury case with a Medicare lien. As we all know, we cannot get a final lien until after a settlement. Well, the final lien amount we received was double what the interim amount we had back in August was and my client stopped treating way before last August (who knows where the numbers came from). Do you have a contact in Medicare that I can call about this lien problem? How are they with negotiating and do you have a contact for negotiating the lien?

-Ohio Attorney

Even though the final lien amount may be incorrect, reimburse Medicare the amount they are demanding within the 60 days, otherwise interest will accrue. While Medicare does not negotiate, per se, there are remedies in the MSP provision for disputing their demand amount.
If the additional claims on the summary are clearly not related to your clients’ injuries you must send in a letter disputing the claims. Unfortunately Medicare will not remove the claims via phone call... they have to have the dispute in writing. If claims you are disputing include diagnosis codes that are related to your client’s injury then you will need to submit medical documentation to support your position. Also, make sure that the final summary does not include any claims that are for treatment past the settlement date.