One of the most challenging parts of any personal injury case is the presence of Medicare liens. If Medicare paid for any part of your client’s medical expenses as it relates to their personal injury case, they must be reimbursed. If they aren’t reimbursed, they will likely seek collection action. They also can apply a lien to the attorney representing the injured party because he or she is likely to receive a portion of the settlement in the personal injury lawsuit. In some cases, the lien may be significant.
It’s critical that you ensure that a Medicare lien is paid prior to a settlement disbursement. However, it’s also important to pay close attention to the list of conditional payments for which Medicare is seeking reimbursement. It’s quite possible to contest certain payments and reduce the lien amount being levied on your client’s settlement. Otherwise, your client may lose more money to Medicare than is required.
When working with Medicare follow these steps:
- Contact Medicare as soon as possible: Contact the Coordinator of Benefits Contractor to determine if Medicare liens exist in your case. In this part of the process, you will have to give specific information about the injury, including the date and time, your client’s name, and a description of the injury. Be as accurate as possible when describing the injury. This information helps determine which bills are related to your case.
- Check the conditional letter to make sure all payments are related to the case: The conditional letter will list all payments that Medicare has made. As is often the case, Medicare will not discern which payments apply to which conditions. There’s a strong likelihood that your client will be asked to reimburse Medicare for payments unrelated to the case. Medicare assigns Internal Control Numbers (ICN) to each medical bill it pays. Within the ICN is the date a medical bill was received by Medicare. Reviewing this information will help you determine if the date of claim coincides with the date of an injury.
- Contest unrelated payments: When payments that are unrelated to the case are found, contest them. Send a letter to the Medicare Secondary Payer Recovery Contractor listing the unrelated charges. Present the information showing that specific charges don’t correspond with the injury case and they will likely drop them.
For more information or to schedule a consultation, please submit our contact request form or call (877) 242-0022.
Disclaimer: The information contained in this article is for general educational information only. This information does not constitute legal advice, is not intended to constitute legal advice, nor should it be relied upon as legal advice for your specific factual pattern or situation.