Changes to CMS Alert

On August 19, 2014, CMS released a NGHP alert revising the October 11, 2011 alert, titled “Liability Insurance (including Self-Insurance): Exposure, Ingestion, and Implantation Issues and December 5, 1980”.

New language in the alert includes:

Any operative amended complaint (or comparable supplemental pleading) must occur prior to the date of settlement, judgment, award, or other payment and must not have the effect of improperly shifting the burden to Medicare by amending the prior complaint(s) to remove any claim for medical damages, care, items and/or services, etc.

Where a complaint is amended by Court Order and that Order limits Medicare’s recovery claim based on the criteria contained in this alert, CMS will defer to the Order. CMS will not defer to Orders that contradict governing MSP policy, law, or regulation.

Click here to read the entire alert.

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