CMS Reporting Recovery Thresholds Stay the Same

On September 26, 2016, the Centers for Medicare and Medicaid Services (CMS) published its annual recovery 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 will remain at $1,000.00 with respect to physical trauma-based liability insurance settlements for the 2016 fiscal year (October 1, 2015 – September 30, 2016). For workers’ compensation and no-fault claims that do not involve ongoing responsibility for medicals, a $750.00 reporting threshold applies for the 2016 fiscal year. This means that if a liability, no-fault or workers’ compensation settlement, judgment award or other payment falls within these categories, there may not be a requirement to report the settlement to Medicare nor 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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