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MEDICARE & MEDICAID

My law firm has focused on the evolving field of Medicare Set Aside & Allocations as a necessary tool to achieving settlement of worker’s compensation and liability claims. We have represented employers & insurance companies in cases where the Medicare Secondary Payor applies to a settlement as a result of a claimant’s age, Social Security entitlement and status, or where the value of the settlement requires consideration of the interest of Medicare.

Medicare can recover its payments for medical services related to claims in all lines of insurance. Medicare is a “secondary payer” with respect to medical expenses incurred as a result of injury caused by the negligence of another. Being a secondary payer, Medicare is entitled to reimbursement for its payment. Medicare’s payments are referred to as “conditional payments,” and are made upon the condition that they will be repaid once payment is received from the “primary payer.” Such primary payers include liability insurance, self-insurance, medical payments, uninsured motorist coverage and underinsured motorists coverage. And here’s the important point: Medicare has a direct right of action against any entity who made payment and any beneficiary or attorney who received payment and failed to reimburse Medicare for its payments.

As of January 2011 the rules governing the reclamation of Medicare funds was made easier and reporting mandatory. Not reporting will provide penalties of $1000 per day/per case.

It’s important that you hire an attorney that understands the new laws and has experience with how your case may be at risk as you have other claims due to a serious injury.

 

   
 

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©2011 Eugene I Kane, Jr.
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Law Offices of Eugene I Kane Jr, represents businesses, employees and employers in Baltimore, Bethesda, Frederick, Germantown, Ocean City, Washington D.C., Baltimore City County, Baltimore County, Frederick County, Howard County, Montgomery County, and Prince George's County. We represent clients on the Eastern Shore, Hagerstown-Cumberland, and the Maryland Suburbs of Washington D.C.