Tuesday, February 3, 2009

Nursing Home, Medicare Lien - New Twist?

Posted by Matthew Garretson

I have a case that settled against a SNF. It was settled at a pre-litigation mediation. I have been trying to find out if MSPRC is asserting a lien against the case. They refuse to accept a copy of the will which shows the son as the personal representative. They are insisting that an estate be opened up, so that they can get a "court document" showing the son is appointed the PR, before they will calculate and release lien information.

The decedent died without any assets or debts. I think the opening of an estate would be a waste of time.

Any suggestions on how to get these people to back off the requirement of a "court document" before they will calculate any claimed lien? Wouldn't my argument be similar to getting the records without having to open an estate, if I show how the PR would be?

-Arizona Attorney

This has been an ongoing battle with the MSPRC because I don’t believe some representatives fully understand the law regarding “opening an estate”. Unfortunately the MSPRC does require a court document, whatever it may be, that authorizes and acknowledges the person signing the release as the personal representative. If you can get the court to sign off on a letter identifying/stating the sole heir, that might work.

This is not a new policy; it has been in effect for sometime. Medicare actually put this policy in place around 2003 or 2004, prior to that Medicare could accept a death certificate and/or will or just a letter from the attorney advising someone was the sole heir. As I understand it, the policy was put into place because lien information was given to someone who claimed to be the personal rep but wasn’t and a big who-ha followed.