LIABILITY SETTLEMENT SOLUTIONS
The jury is still out on the extent to which parties in liability settlements must consider Medicare’s interests in future medical costs. There are questions about whether CMS can seek reimbursement for injury-related medical care from the settling parties or deny payment for this care after a liability settlement. For a better understanding and practical guidance on Medicare Secondary Payer considerations in future medicals, please review Tower’s White Paper, Navigating Through the Fog: Medicare, Future Medicals & Liability Settlements.
Tower MSA Partners’ compliance experts are available for consultation to alleviate the uncertainty and risks surrounding the issue of future medicals and Medicare in liability settlemt. We will analyze your claim, recommend the best approach and implement the most effective settlement solution. Potential solutions include:
- Social Security Disability Verification/Medicare Entitlement Search
- MSP Compliance Opinion Letter
- Liability Medicare Set-Aside (LMSA) Report
- Medical Cost Projection (Includes non-Medicare covered services)
- Life Care Plan
While there is uncertainty about future medicals, one thing is certain: resolution of Medicare conditional payments at the point of settlement is an imperative. Failure to properly reimburse Medicare may lead to federal action against the claimant, the claimant’s attorney, the insurance carrier, or self-insured entity. Available to all parties in settlements, Tower’s Simplified Medicare Conditional Payment Resolution solution includes:
- Determination of Medicare eligibility
- Investigation of Medicare conditional payments with CMS’s Benefits Coordination and Recovery Center (BCRC) or a Medicare Advantage Plan (MAP), if enrolled in such a plan
- Negotiate/Dispute conditional payment charges unrelated to the injury
- Submission of settlement information, including procurement costs, with request for final demand from BCRC or MAP
- Payment of final demand to Medicare or MAP
Related:
NAMSAP Bulletin Highlights Meeting with CMS on Liability MSA Reviews