Unfortunately, some beneficiaries of Medicare are finding themselves in difficult situations, as the money they thought they would be receiving from a personal injury case are sometimes going to the Federal Centers for Medicare and Medicaid Services. To combat this problem, a new law is going to be put in place to try to assist seniors in this situation get what they deserve.
The problems lie within the Medicare Secondary Payer process. Generally, if a settlement occurs against another party, Medicaid is entitled to receive reimbursement for what was spent for the medical care of the beneficiary. In this case, Medicaid is referred to as the secondary payer, while the other party or liability insurer is the primary payer. However, Medicare has to figure out how much they are owed and report their expenses in order to collect. Further complications can arise when Medicare’s final tally is more than their initial estimation of how much they are owed. This process can become complicated, and often times beneficiaries get the short end of the stick.
The new law is called the Strengthening Medicare and Repaying Taxpayers Act. The law sets deadlines for Medicare to state how much they are owed on a website that litigants can access from home. Additionally, the new law will require the following:
- Medicare beneficiaries must notify the agency within 120 days of the expected settlement date. At that point, they have an additional 65 days to report what is owed. 30 day extensions are available upon request.
- Medicare must post any medical payments made to providers as part of the settlement process within fifteen days.
- Agencies are given an eleven day window to respond if a beneficiary has a dispute with how much Medicare is owed.
- Lastly, the law puts a limit of three years from the date of an anticipated settlement in which Medicare can request repayment.
Medicare has stated that they are “commited to doing a good job” and “maintaining a high level of customer service”.
