Proposed Legislation Would Impact Medicare Reimbursement in Personal Injury Claims
As I have previously written, it is essential that an attorney handling personal injury claims have a sound knowledge of reimbursement and subrogation issues. Otherwise, the attorney will be ill-equipped to protect his injured client and maximize any recovery for that client. Many issues and facts impact the rules applicable to each specific case. For instance, does the injured party have health coverage through a private plan? Is that private plan provided through an employer? If the injured party does not have private coverage, do they have coverage through Medicare or Medicaid? Is the coverage through some other public source, such as the Veterans' Administration? Each of these presents unique issues and rules.
I could write exhaustively concerning the various aspects of dealing with each type of coverage and its unique issues. However, I truly believe that most attorneys who handle personal injury claims would agree that dealing with Medicare is the most frustrating of any of these. Imagine a system that requires (with the full force of Federal law) the injured party and his legal counsel to reimburse it from a settlement or judgment, then will not communicate effectively or timely so that those parties can fulfill their legal obligations. That is Medicare. Attorneys for personal injury claimants often wait months (or longer) for Medicare to respond to efforts at repayment. A reporter at The Miami-Herald did an excellent job documenting the frustrations of lawyers attempting to comply with Medicare laws on behalf of their injured clients. At our office we have experienced that frustration first-hand. In addition, just imagine how much money is actually available to our government in attorney trust accounts throughout our country.
Finally, those knowledgeable and involved in the Medicare reimbursement process are beginning to discuss methods that would force Medicare to act in a just and timely manner. In March, legislation was introduced into the U.S. House of Representatives on this issue. The proposed legislation has support from varied groups, including groups often at odds in personal injury claims. Despite their differing opinions on many issues, these varied groups all seek changes in Medicare reimbursement procedures that would make the process quicker and more efficient. What does the proposed legislation do? The bill itself is fairly short. It simply provides time limits for Medicare to respond when parties seek to reimburse prior payments for medical treatment. That is a much needed change that should certainly be discussed and considered. While I do have some initial concerns with the bill, including whether a potential defendant in a claim could use the provisions to its benefit in litigating that claim, it is a much needed start to resolving a frustrating issue for injured parties. It is also my hope that Medicare will act to comply with any enacted time requirements so that health care costs are not unnecessarily shifted from private insurers to our government.
