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Medicare: Year In Review Medicare: Year In Review

Medicare: Year In Review

It's that time of year—Time to reflect on 2018 and look forward to 2019. 

We saw several changes to the Medicare Secondary Payer collection system in 2018. Here are some highlights:

  • Two new contractors were hired: one to address conditional payment reimbursement efforts, another to address future medical care obligations and Medicare Set Aside agreements. Understandably, the contractors have referred matters to the Department of Treasury more aggressively, and there are reports of increased calls and letters from collection agencies seeking reimbursement for outstanding conditional payments made by Medicare.
  • New Medicare cards were issued to beneficiaries in an effort to protect Medicare beneficiaries' confidential information.
  • An updated conditional payment portal was implemented to assist Medicare beneficiaries in obtaining information and resolving conditional payment issues faster. 
  • A national study concluded that the Center for Medicare and Medicaid Service's (CMS) processing time has improved, and it issued more conditional payment letters this year. 

What's coming in 2019?

We have heard discussions throughout 2018 that CMS may begin to require Medicare Set Aside (MSA) agreements or other considerations to address a Medicare beneficiary's future medical care needs with liability settlements, similar to what it requires with worker's compensation settlements. The Office of Management and Budget recently issued proposed rulemaking to address Medicare Secondary Payer obligations in the context of automobile and liability insurance, no-fault insurance and worker's compensation recovery. The impact could be that CMS begins to require parties to include a liability settlement to address responsibility for a beneficiary's future medical care needs as part of the settlement agreement—a Liability Medicare Set Aside agreement (LMSA). There is no deadline for this proposal, but the timetable for the Notice of Proposed Rule Making is September 2019.

We will continue to monitor the Medicare Secondary Payer obligations and inform you of changes that impact employers' or insurers' obligations. If you have any questions regarding your Medicare obligations, please give attorney Ann Stewart a call.

This publication is intended for general information purposes only and does not and is not intended to constitute legal advice. The reader should consult with legal counsel to determine how laws or decisions discussed herein apply to the reader’s specific circumstances.
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