Fixed Percentage Recovery Option Available in Certain Liability Settlements

The MSPRC has implemented a new fixed percentage recovery option that will be available to certain beneficiaries effective November 7, 2011.

The “Fixed Percentage Option” gives beneficiaries who have physical trauma based Liability insurance (including self-insurance) settlements of $5,000 or less the ability to resolve Medicare’s recovery claim by paying Medicare 25% of the total liability insurance settlement instead of using the current recovery process.

Information, instructions and model language are listed in the Medicare Beneficiary & Attorney tool kit sections of the MSPRC’s website. Links to this information are provided below.

Link for beneficiary: http://www.msprc.info/index.cfm?content=includes/toolkits/beneficiary_nghp

Link for attorney: http://www.msprc.info/index.cfm?content=includes/toolkits/attorney_nghp

 

CMS Announces New Fixed Percentage Option Regarding Medicare’s Recovery Claims for Certain Liability Settlements

The Centers for Medicare and Medicaid Services (CMS) has announced a new fixed percentage option regarding Medicare’s recovery claims for certain liability (including self-insurance) settlements beginning November 7, 2011. To review CMS’ announcement, click here www.msprc.info

This option will be available to beneficiaries who receive certain types of liability (including self-insurance) settlements of $5,000 or less. Under CMS’ new plan, a beneficiary who elects this option will be able to resolve Medicare’s recovery claim by paying Medicare 25% of his/her total liability settlement instead of using the traditional recovery processes. Continue reading “CMS Announces New Fixed Percentage Option Regarding Medicare’s Recovery Claims for Certain Liability Settlements”

CMS Releases Policy Memo Addressing Liability MSAs

The Centers for Medicare and Medicaid Services (CMS) has released a policy memorandum (dated September 29, 2011) pertaining to liability Medicare set-aside (L-MSA) arrangements.

To obtain a copy of CMS’ September 29, 2011 memo, click here.

Per CMS, “[t]he purpose of this memorandum is to provide information regarding proposed Liability Medicare Set-Aside Arrangement (LMSA) amounts related to liability insurance (including self-insurance) settlements, judgments, awards, or other payments (‘settlements’).” Continue reading “CMS Releases Policy Memo Addressing Liability MSAs”

CMS Announces $300 Threshold for Certain Liability Settlements

The Centers for Medicare and Medicaid Services (CMS) has announced a $300 monetary threshold for certain liability cases.  If the requisite threshold criterion is met, Medicare will not seek recovery against a beneficiary’s settlement, judgment, award or other payment. 

To learn more about CMS’ new $300 liability threshold, including the various criteria that must be met, visit http://www.msprc.info/ and http://www.msprc.info/index.cfm?content=includes/toolkits/insurer_nghp.

U.S. v. Stricker

U.S. v. Stricker
CV 09-BE-2423-E, 2010 WL 6599489
(D. N.D. Ala., September 30, 2010)

In December, 2009, Medicare filed a lawsuit (U.S. v. Stricker) in Federal District Court through which it sued the plaintiff law firms, the defendant corporations and their insurance carriers for their alleged failure to protect its interests regarding conditional payments in connection with a large tort settlement in 2003. As part of this action, Medicare claimed double damages against the primary payers.

This case was ultimately dismissed on the technical grounds of statute of limitations. The court applied the statute of limitations contained in the Federal Claims Collection Act and ruled that a three year statute of limitations governed Medicare’s action against the primary payers and that a six year statute of limitations applied in regard to the plaintiff law firms. Based on the facts, the court found that Medicare failed to file its action within the applicable statute of limitations.

To review a more detailed analysis of the court’s decision in this case, see the author’s article entitled U.S. v. Stricker Lawsuit Update: Analyzing the U.S. v. Stricker Lawsuit & the Court’s Ruling as contained in NuQuest/Bridge Pointe “Settlement News,” October, 2010. This article can be obtained at dev.nqbp.com.