Despite steadily declining activity in mass toxic-tort dockets, attorneys are still settling cases and, increasingly, face complicated issues presented in the settlement context. When the case encompasses Medicare issues, the situation becomes even more complex.
The Medicare, Medicaid and State Children’s Health Improvement Program Extension Act of 2007 (MMSEA) mandates that responsible reporting entities, including insurers and self-insurers, submit data electronically to the Centers for Medicare and Medicaid Services (CMS) through their coordination of benefits contractor for all settlements or judgments paid to personal-injury plaintiffs who are Medicare beneficiaries. The legislation requires the claimant or the defendant to settle Medicare’s interest before the defendant disburses any settlement funds. The legislation also provides that CMS has a right to intervene in any action related to events giving rise to the need for the services for which Medicare paid. Further, if the claimant does not reimburse Medicare, Medicare has the right to seek reimbursement from the primary payer to resolve the Medicare lien.
