Medicare: Their Bite is Catching up with their Bark!

    The boy who cried, “wolf”? Howling at the Moon? Here at The Lien Project, we are just going to keep barking about Medicare liens!

Listen Up.  Medicare has rolled out another program as part of its Conditional Payment Recovery efforts – this time to include conditional payments made AFTER the date of settlement as part of their Final Demand.

Sounds like a lot of bark but no bite? Think again. 

It’s not unusual for clients to continue receiving medical care at the time their case settles. Indeed, this is often why the case resolves. 

Plaintiff's counsel would notify CMS of a PI claim, receive a Conditional Payment Notice [CPN], notify CMS when the case resolves, and get a Final Demand which would include CMS payments made up until the date of settlement.

While Medicare’s obligation to pay for future care remained secondary, for care which was arguably paid for in the settlement, resolving the “past” CMS lien was a separate process from handling potential LMSA issues.

Recently, we learned that a CMS contractor issued a CPN generated after CMS received notice from a liability carrier about a significant settlement.  What is different? It includes payments made from the date of the incident through the date of the CPN – NOT the date of the settlement.   

CMS is thus seeking to recover payments it made for care both before and after the settlement.

How do you deal with such demands?

Let The Lien Project Help!

I am going to be the big dog on the porch right now. Recent case law makes clear that unless you work the issue from early on in the case, you may be creating the problem (see, Weis v. Azar, Dist. Ct.  Maryland, Dec. 8, 2018).

Adding complications to your complications, the legal malpractice traps here are noteworthy. The trend of U.S. Attorneys’ offices pursuing plaintiff’s firms for Secondary Payer Act Compliance is on the uptick https://thelienproject.com/blog/news/the-feds-are-coming and the threat of potential False Claims Act liability should raise everyone’s red flag.

CMS compliance in your personal injury practice is not optional. Here at TLP, we have systems and strategies in place to not only remedy your complications, but to boost your bottom-line bravado. 

We are trial lawyers helping trial lawyers.

We are not lone wolves; we are running in the pack...I meant to say we are running the pack! 

We are here to help.

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