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Medicare Liens

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Posted On 01.22.13 by in General Information

 

When Medicare pays expenses of medical care or prescription drugs for a person who was injured in an automobile accident or other personal injury, the victim must repay Medicare if they get money from a lawsuit or settlement.  Under the law, the victim is required to pay back Medicare-paid expenses that are causally related to the accident.

This has always been a big headache for personal injury lawyers and their clients.  For years, dealing with Medicare has been one of the most difficult parts of the case.  In order to figure out how much money our clients need to pay back, we would have to get a proposed lien statement from Medicare.  This usually required a lawyer or a paralegal spend a good 90 minutes on hold to talk to an attendant to even start the process.  Liens are often miscalculated, but outlining the unrelated expenses was often a process in futility.  Even worse, sometimes we would have a final number, we settle the case, and then Medicare tells us that the number is actually higher (meaning less money for our clients).  The whole process was frustrating.

Because of the advocacy of lawyers across the country, the process is seeing some changes.  The SMART Act (scroll down to Title II) is meant to streamline the process of dealing with Medicare liens.  It will include the following:

  • A web portal containing accurate and timely information about Medicare payments, and whether they are potentially subject to reimbursement;
  • A specific timeline requiring Medicare to respond to information regarding lien amounts;
  • A specific timeline to resolve discrepancies upon notice from the Medicare recipient or his/her attorney;
  • A limit on the amount of time (3 years) that Medicare can seek payment for medical services

This new law will help in two major ways.  First, lawyers can spend more time working on the substantive issues of cases, and less time dealing with bureaucratic red tape.  Second, clients will get their money from settlements or verdicts much quicker than before.  The Medicare process is famous for holding up payments, because lawyers cannot disburse money until they are sure Medicare will get what they are entitled to.  We have seen cases where money has been tied up for a year after the settlement.

Contact Us

If you are a Medicare or Medicaid recipient and you want to know if you must give part of your accident settlement back, contact our personal injury lawyers at 1-800-776-4529, or online.

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