Top 10 MSP-Related Events of 2011 – Number 5

Medicare Set-Aside Blog on January 9, 2012 | Posted by


New Conditional Payment Reimbursement Policies



Much like the dismissal of the Chickasaw Nation, CMS took additional subsequent remedial measures to deal with the embarrassment before Congress last summer. Following the questioning regarding the cost of pursuing nominal recoveries, CMS suddenly issued several new policies for conditional payment recoveries in liability insurance settlements. In September, CMS announced that it would no longer pursue recovery in claims that settled for less than $300. Not sure how many of those cases you see, but it was a start. Then, in November, CMS announced that in cases settling for less than $5,000, it would accept a fixed percentage in satisfaction of unknown conditional payment obligations. An incredible costly alternative to actually requesting the information and resolving the debt cost effectively, but again progress on CMS’ part nonetheless. Then finally, in December, it announced a self-calculated final conditional payment amount option that will become available in February for cases that settle for less than $25,000. Again, with all of the electronic data available to the federal government, it is about time that such an option was contemplated but the dollar limit will exclude the vast majority of cases with a reimbursement obligation, so it is unlikely to affect those most in need of MSP reform. Regardless, these are promising signs that CMS is headed in the right direction and willing to ease some of the burdens stemming from the MSP. Hopefully, it will continue in this direction in 2012.