CMS Reporting Recovery Threshold Change for Physical Trauma Liability Settlements Beginning 1/1/2017

On November 15, 2016, the Centers for Medicare and Medicaid Services (CMS) published an alert for reporting thresholds for certain liability insurance, no-fault insurance, and workers’ compensation settlements, judgments, awards or other payments. CMS has advised that the thresholds for reporting settlements, judgments awards or other payments after 1/1/2017 with respect to physical trauma liability insurance settlements will change from $1,000.00 to $750.00. For workers’ compensation and no-fault claims that do not involve ongoing responsibility for medicals, the $750.00 reporting threshold remains the same. Therefore, if a liability (involving physical trauma), no-fault or workers’ compensation settlement, judgment award or other payment falls below $750.00 the payment would not need to be reported to Medicare and there would not be a requirement to repay conditional payments. These calculations are an annual requirement started under the Strengthening Medicare and Repaying Taxpayers Act, Pub. L. 112-242, 126 Stat. 2380.

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