Thursday, May 27, 2010

Settling Medicare's Lien Amount

Question
In a situation where an injured party on Medicare has ongoing medical treatment associated with a personal injury claim or suit that may not settle for many months or a year or more, does requesting Medicare payment information prior to settling a claim or lawsuit start the clock running on interest owed on Medicare's lien amount for medical payments made by by Medicare? What benefit is there if any to requesting this information at the outset of a cae or before a case settles as opposed to waiting until after settlement occurs and thereby avoiding interst accruing on Medicare's lien amount?

Answer
The MSPRC (Medicare Secondary Payer Recovery Contractor) begins identifying claims for recovery when it receives notice of a pending no-fault, liability, or WC matter. However, it does not issue a formal recovery demand letter until there is a settlement, judgment or award. It is against the date of that formal Final Demand Letter that interest accrues. Resolving Medicare's interest in a settlement takes time so starting early will allow you to have an ongoing accounting of Medicare's interest in your case so starting early is crucial.

Sylvius von Saucken