Personal Injury Law

New Reporting Requirements For Companies That Make Payments to Medicare Recipients in Personal Injury Lawsuits or Workers' Compensation Claims

By Kenneth Odza

By Guest Blogger Emily Grande

A few weeks ago, I attended the Grocery Manufacturer Association's webinar on Consumer Complaint Management – Current Issues and Effective Procedures. One important topic covered was the new Medicare reporting requirements for self-insured companies that are defendants in personal injury lawsuits or that are paying workers' compensation claims. If a company satisfies a judgment or settles with a personal injury plaintiff who is a Medicare recipient, the company must report the payment to Medicare, as required by Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007. These new reporting requirements were enacted to save the government's health care programs money by arming them with the information needed to recover payments made to Medicare recipients for medical expenses in personal injury and workers' compensation cases. In such cases, the defendant, not Medicare, is responsible for the plaintiff's health care bills. The eye-popping penalty for a company's failure to report payments to Medicare recipients is $1,000 per day per claim. In addition, Medicare can pursue legal action against the settling company if it fails to ensure that Medicare is reimbursed regardless of whether the company has already paid the plaintiff. As if that weren't enough, Medicare can pursue double damages.

The registration deadline for the program was September 30, 2009, but there do not appear to be penalties for failing to register on time. The first required reporting period is the second quarter of 2010. All personal injury settlements made after January 1, 2010 must be reported, and all workers' compensation claims considered 'open' on January 1, 2009 must be reported.

A guide for responsible reporting entities can be found at the Centers for Medicare & Medicaid Services website.

The presenter at the GMA's webinar was attorney Thomas S. Thornton III and his presentation slides are available here.

Full post as published by Food Liability Law Blog on December 10, 2009 (boomark / email).