Medicare Liens

Posted by Matt Garretson

Question:
We settled a case on behalf of one of our clients. We are disputing the amount of the Medicare Lien and have filed an Appeal with Medicare. We received a letter demanding payment and interest regardless of our dispute with Medicare and the pending appeal. Their Pro Forma Instructions state that we must pay the total amount plus interest now regardless of the pending appeal, and that if we are successful on the appeal the difference would be refunded.

Has anyone been successful in getting Medicare to waive the interest that's charged during the pendency of the appeal?

New York Attorney

Answer:
Assuming the disputed charges can be adequately substantiated, I recommend paying the agreed upon charges (less procurement offset). The principal of unrelated and associated interest will be waived if successful on appeal.

I also should add that Medicare typically only waives interest prior to a successful appeal if there is a mistake in the issuance of the final demand. In other words, if the case hasn't actually settled (funds weren't received or agreement wasn't signed) then they would consider waiving interest prior to successful appeal.

My best,
Matt Garretson