Medicare And Medical Reimbursement Rights From Insurance Claims

Medicare and Medical reimbursement in personal injury claims matters is a subject that is unknown to most accident victims making injury claims against insurance companies. Medicare has a right to recover the money it pays medical providers that have billed Medicare for treatment provided to personal injury accident victims in situations where the accident victims obtain a settlement or verdict against a third party defendant who caused the injury by means of an automobile accident, pedestrian accident, truck accident, medical malpractice, or other acts that were performed in a negligent manner causing injuries. Medical has the same right to reimbursement under California law that Medicare has under Federal law. The positive news is that the amount of reimbursement is not 100% of the money paid out by Medicare or Medical. They reduce their lien rights by a formula or percentage based on the amount of legal fees and litigation costs incurred by the accident victim in obtaining the out of court settlement or jury trial verdict. The Medicare reduction averages 25%-30%, and Medical approximately 25%. Unfortunately both Medicare and Medical can sometimes take months to send their final lien amount causing long delays in the final payout of the settlement proceeds. As the Palm Springs Personal Injury Lawyer who deals with these government agencies on a daily basis I have firsthand knowledge as to how frustrating it is to try and get them to be more efficient in processing these liability claims cases. I settled an assault and battery case in October of 2011 and sent Medicare all the documents regarding the settlement of the insurance claim. I sent the material by certified mail. I had proof the envelope was delivered. I called Medicare yesterday to find out why we have not heard from Medicare since they are supposed to send the final lien letter within 65 days of their receipt of the settlement. I was told that they never received the correspondence and that we would have to start the process over even though I had proof of mailing and their receipt. I have had the same thing happen on numerous occasions in the last 15 months. The problem for my clients is that the defendant's insurance company won't send out the settlement check until I can produce the final Medicare lien letter. I once had to have an automobile accident victim client call Mary Bono's office to get help since Medicare had delayed issuing a final lien letter for 5 months. The help of the Congressional office helped. Contact Barry Regar APLC for all personal injury and insurance claims occurring in Palm Springs, Palm Desert, Indio, or anywhere in the Coachella Valley