Trying to make sense out of Medicare Set-asides. Providing and discussing practical advice for an unnecessarily complicated process.

Thursday, January 10, 2008

Big News: New Legislation

GovTrack: S. 2499: Text of Legislation (Scroll down to Section 111)

Late last month the Federal Govt greatly expanded the Medicare Secondary Payer Act that is going to affect Medicare Set-asides, workers comp and general liability cases. What the government is going to create is a reporting requirement for the settlement of WC cases and GL cases where the claimant/plaintiff is on Medicare. The carrier will be responsible for ascertaining Medicare status.

After settlement the carrier will have a reasonable amount of time to report the terms of the settlement to the government. Failure to do so will result in a fine of $1,000 per day. That is correct per day.

All of the parameters are to be worked out by the Sec of HHS over the next 18 months. The law will go in to affect in July of 2009.

The big news, of course, is that the government is going to be monitoring GL cases. This means that the parties would be foolish to submit settlement information without containing a Medicare Set-Aside.