Medicare Lien Discovered After Resolution of Case

Posted by Mary Skinner

Question:
We have a client that did not tell us she had Medicare. We discovered it after mediation and the case was resolved. We believe there is a $42,000 lien and have written to Medicare for information, but have had no response. What can we do?

Answer:
If you have reported this to the COB (Coordination of Benefits) at 1-800-999-1118 to establish a record and then subsequently sent a request for conditional payments paid along with a HIPAA authorization to the MSPRC, Medicare has 45 days to respond. If it has been longer than 45 days, then I would call the MSPRC at 1-866-677-7220 and have them expedite your request.
In the event that you have not reported it the COB then you will need to do that. Without a record established by the COB, the MSPRC is unable to pull claims and provide you with a conditional payment summary. Unfortunately, until you have Medicare's final demand amount you can not disburse the net settlement proceeds to your client. You can however take attorney fees and expenses. Please let me know if I can be of further assistance.