Tuesday, August 25, 2009

Putting Medicare's Name on the Settlement Draft

Posted by Matthew Garretson

Settled a case with Westfield today and was told by the adjuster that, under the new guidelines, they must now put Medicare on the settlement draft. I understood that they had to verify whether the claimant had received Medicare benefits - which we are happy to cooperate with them. However, putting Medicare on the settlement draft isn't doing anyone any good.

How is everyone dealing with this?


While that isn't a requirement at all under the new MMSEA, some defendants are doing this as an extra-protective measure. If they put Medicare's name on the check, it takes a minimum of 10 to 12 weeks for Medicare to process it and send you the funds back (and, of course, it means that your Medicare reimbursement claim must be finalized during that timeframe). A much preferred route is to show up at the settlement conference with an up-to-date conditional payment summary from Medicare and be able to demonstrate to the defendants you are only 30 to 45 days away from getting a Final Demand from Medicare (once you ink the settlement agreement). That leaves you with two options: 1) if the conditional payment summary you have at the time of settlement is current, you might be able to agree to have them hold back 1.5x's that amount (or you hold it back in your IOLTA) while the claim is finalized or perhaps they just hold the entire proceeds while you complete the Medicare reimbursement claim. Either way, 30 to 45 days (assuming no waiver or appeal is required) is much better than waiting 10 to 12 weeks.

Hope that helps.

My best,
Matt Garretson