As a Huntsville personal injury attorney one of the most frustrating feelings is settling a case and having to tell your client they are going to have to wait on their settlement monies until Medicare releases its final payment letter. For example, our firm resolved a Huntsville car accident claim in November 2009 and it wasn't until May 2010 that we finally got the amount of the Medicare lien. The Medicare Secondary Payer (MSP) system is set up so that Medicare does not pay for healthcare services when a third party such as an insurance company or defendant in a personal injury lawsuit is legally responsible for those medical bills. For example, if John Doe is on Medicare and he is injured in a motor vehicle accident when another driver runs a red light when John Doe goes to the hospital Medicare will initially pay those bills; however, under the Medicare Secondary Payer Act the law states Medicare should be reimbursed what it paid if the injured party makes a recovery from the at fault party. As a Alabama personal injury lawyers we do not have any problem reimbursing Medicare out of our client's settlement proceeds, the problem stems from getting Medicare to provide an accurate and timely response to a request for the amount of their lien. As illustrated by the example above this process can take months and even years.
A solution to the Medicare lien problem is in the works. The Medicare Advocacy Recovery Coalition (MARC) has been working on a bill with the Association for Justice (AAJ) that will hopefully refine the arduous process for obtaining a Medicare lien amount. One part of this new bill would allow the Plaintiff's attorney to calculate what they believe Medicare is owed and send that amount in to Medicare. Once Medicare receives the proposed amount they would have 75 days to appeal that calculation. The other option would be for the Plaintiff's lawyer to request a final lien amount and CMS (Center for Medicare and Medicaid Services) would have only 60 days to respond or lose its right to reimbursement. The passage of this bill is vitally important; therefore, we strongly encourage everyone to call and write their congressman and ask them to vote for MSPEA (HR4796). If this bill fails to pass many injured clients will continue to wait for their settlement monies.
