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Trial lawyers specializing in personal injury and civil litigation

Lawyers complain about delay in determining Medicare lien amounts

The Bellingham Herald published the accounts of several lawyers and clients who had waited as long as 18 months for confirmation of Medicare lien amounts.  While Courts keep injury victims on a tight schedule to resolve claims, it is frequently impossible to know just how much of any settlement must be repaid to Medicare (or Medicaid) authorities to repay medical expenses.  The government entities have a statutory right of repayment and a scheme for determining lien amounts that frequently requires victims to settle their underlying claim without knowing what they will actually receive until months--or even years--later, when Medicare finally responds.

The problem exists in all areas of the country but is apparently worse in some regions, as a result of no-bid exclusive contracts with third-party collection services.  Our firm has experienced the same problem:  a 2006 settlement for $100,000.00 was held up and could not be paid to the victim for 13 months, awaiting a Medicare response.  Like the lawyers quoted in the Washington newspaper, we also have experienced occasions when it was impossible to even identify a live body with whom to discuss lien amounts--although it appears that claims are being handled more efficiently in the midwest since the winter of 2008-2009.  A new statute requiring early notice to Medicare of potential liens is expected to result in a more efficient claims-management process, however, since the new procedure will also identify more potential repayment claims, it is not clear that claims will actually be processed more quickly.

Thompson O’Neil, P.C.
309 East Front Street
Traverse City, Michigan 49684
Toll Free: 1-800-678-1307
Fax: 231-929-7262