Gardberg & Kemmerly, P.C. Attorneys at Law

Medicare Repayment Reforms Coming Soon


For the personal injury plaintiff and attorney, working with Medicare to resolve a lien has been unclear and difficult. Recently, both the United States Senate and House of Representatives passed the Strengthening Medicare and Repaying Taxpayers Act ("SMART Act") in an effort to streamline the resolution process between the plaintiff and Medicare. The SMART Act awaits the President's signature before becoming law.

The emphasis of the SMART Act is to help plaintiffs resolve their Medicare lien situation in a timely fashion while simultaneously helping Medicare recover more of the money they spend in medical treatment for an injured plaintiff. The details of the bill have not been fully covered but some of the pertinent information is:

1. Effective January 1, 2014, certain liability claims will be exempt from reimbursement if the claim does not meet a minimum threshold for settlement.

2. CMS will issue a final demand prior to a settlement agreement.

3. There will be a three-year statute of limitations for CMS to seek reimbursement.

Roy Franco, a co-chair member of the Washington-based Medicare Advocacy Recovery Coalition (MARC) stated, "[This] produce[s] a triple win. Medicare beneficiaries will be able to settle claims, companies will be able to resolve disputes faster and more efficiently, and the Medicare Trust Fund will be repaid quicker and more efficiently."

For plaintiffs on Medicare, injured through the negligence of another person, the SMART Act may soon provide assistance in the settlement process. An experienced personal injury attorney will be able to provide guidance throughout your legal claim, especially when dealing with Medicare liens.

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