Tuesday, February 23, 2010

Do Hospitals Have The Right To Bill Medicare After Four Years?

My client died four years ago as the result of a hospital's medical malpractice. After the malpractice was committed, my client spent three weeks in the same hospital's intensive care unit before she died. Except for a few tests, the hospital never billed Medicare for the three weeks my client spent in the ICU.

We have just settled the case against the hospital and the doctors, though the release has not yet been signed. Does the hospital (four years after the fact) have the right now to bill Medicare for care in the ICU? Would Medicare have a lien against the proceeds for such care? What, if anything, should be done with regard to Medicare?

Thank you for your help.
Massachusetts Attorney

Many times when the tortfeasor in a medical malpractice is the hospital itself, they will not bill Medicare nor will they try to collect from the client or the patient. If they haven't billed the client for the ICU stay, there's a chance they are not going to bill the client.

As for Medicare, you should still contact Medicare. While the hospital may not have billed for their charges it is very possible and most likely that the doctors, if they were not a defendant in the case, would have submitted claims for their services. Hence there would be claims out there for which Medicare would seek reimbursement. If there are not any claims out there, then Medicare will provide a discharge for a zero interest. That ensures that you satisfied Medicare's interest and complied with federal statutes.

Hope this helps!

My best,
Elizabeth Vish