A new Medicare law, effective July 1, 2009, requires liability insurers (which include carriers who write CGL policies, auto policies, homeowners’ policies and those defendants who are self-insured such as supermarkets) to determine and report whether a claimant is covered and is entitled to Medicare benefits. If the claimant received Medicare benefits Medicare is holding out both hands to make sure they get 100% reimbursement.

The growing Medicare shortfall in Washington has many politicians looking for ways to bridge the funding gap. As a result a new law, effective July 1, 2009, has been enacted which requires liability insurers (which include carriers who write CGL policies, auto policies, homeowners’ policies and those defendants who are self-insured such as supermarkets) to determine and report whether a claimant is covered and is entitled to Medicare benefits. If the claimant received Medicare benefits during their treatment for the injury, Medicare is holding out both hands to make sure they get 100% reimbursement, despite the comparative negligence of claimant.

This new law will pose new challenges for plaintiff’s attorney, the insurance carrier for the defendant and the mediator who is attempting to resolve the claim. If the attorney or insurance carrier does not comply, they risk being sued by the Government for reimbursement up to five years post-closure and monetary fines.

What is the new law?

On December 29, 2007, President George Bush signed into law the “Medicare Medical, and SCHIP Extension Act of 2007.” The new legislation amends the Medicare Secondary Payer Act (MSA) by establishing new reporting guidelines beginning July 1, 2009. Under the new rules, all liability insurers, and self-insurers will be required to determine whether any individual who files a claim against the insurer or any entity insured or covered by the insurer is entitled to Medicare benefits. If so, the insurer must provide Medicare with that individual’s identity and any other information that maybe required under the law. This information must be furnished to Medicare within the time specified by after the claim is resolved through settlement, judgment, award or other payment (regardless whether or not there has been an admission or determination of liability). If an insurer fails to notify Medicare in accordance with these guidelines, a civil penalty of $1,000 per day will be charged per claimant. The new legislation clearly indicates a shift in policy which will result in the federal government monitoring general liability claims more closely. The fines represent a new enforcement push by Medicare to hold attorneys and insurers liable.

What does it mean for Plaintiff’s Attorney?

Plaintiff’s attorney will begin to take a closer look at the case he or she accepts. The attorney should change the client intake form to ask very comprehensive health related questions, whether the client is entitled to Medicare, how long has he been on Medicare, which type of Medicare and whether the claimant has used Medicare to obtain treatment for his/her injuries. The client should be advised in detail about the new Medicare Recovery Act and that Medicare is looking for 100% reimbursement, not taking into account if there is any comparative negligence. The client should be told there is no hiding from Medicare because it will be notified upon a settlement or judgment and the lien may take months if not years to resolve.

Think twice before accepting a small personal injury case involving Medicare recipients where liability is disputed. A settlement amount will have to cover Medicare charges up to 100%, attorney fees and provide money for the plaintiff. If that type of recovery does not seem likely consider rejecting the case.

However, Baby Boomers are increasing and may be a good part of an attorney’s personal injury practice. It is estimated that in the next couple of years, approximately 25% of the Country’s population will consist of baby boomers who are Medicare recipients. If the claimant has undergone limited treatment using Medicare and needs additional treatment, consider advising the healthcare provider to bill plaintiff directly or consider finding a doctor who will take the treatment on a lien. This way a Medicare lien will be avoided or at least a very minimal lien incurred. If liability is undisputed, have the medical provider bill the insurance carrier directly.

What if the attorney has a case where Medicare has a substantial lien? If it is before July 1, 2009, consider settling the claim before that time. If you cannot, again advise the client of the new Medicare Recovery Act and the reporting requirements.

If there is a settlement and Medicare does not know about it and mistakenly pays for services it has a right to recover, it can go after the attorneys whose fees are paid out of the settlement. Also the Medicare recipient can lose his or her benefits. Lawyers could be exposed to malpractice claims for not handling a client’s benefits properly. Insurers can be liable for monetary fines for failure to report. If a plaintiff loses his Medicare benefits, the plaintiff may bring a legal malpractice claim against the attorney and a bad faith claim against the insurer for not making sure Medicare benefits were protected.

After July 1, 2009, makes sure the claim is settled for an amount that will cover the Medicare lien. It may be possible to comp the lien, but do not count on it. In making settlement demands, assume that you will pay Medicare 100% reimbursement in what is paid out. Make sure all charges refer to the injuries that your client sustained. Medicare will not be speedy to resolve these claims, so discuss with the client about holding the amount in a trust account until the CMS lien is resolved rather than disbursing the entire amount owed to plaintiff.

It is unknown whether plaintiff’s attorney will have to worry about set asides calculations for future medical care and submit them to Medicare for approval. Currently, there is no formal process of liability settlements for future medical care.

Finally, negotiations with the liability insurance carrier will become more difficult. They will demand information about your client, such as social security number, so that they can comply with the requirements and avoid fines. Also, even though Medicare may ignore the comparative negligence issues, Insurance adjusters will take the position that despite Medicare’s 100% reimbursement, it will not pay 100% of the medical bills. An insurance carrier will not want to increase the cost of a claim and stand firm on its position.

This new law will pose challenges for the plaintiff’s attorney who is attempting to resolve the claim. The key is to be aware of the Medicare Reimbursement ActComputer Technology Articles, and to prepare the parties prior to a settlement of the barriers that the Medicare Recovery Act may present.

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ABOUT THE AUTHOR

Elizabeth A. Moreno is a mediator and arbitrator and is a principal of Centurion Mediation, LLC which provides quality mediation for less than $300 per hour at a location convenient to the parties in the Los Angeles, California area. Ms. Moreno has mediated and arbitrated over 300 matters. She is serving a three year appointed term with the State Bar of California ADR Committee. Ms. Moreno practices in the following areas Insurance, Personal injury, Employment, Business Disputes, Real Estate, Malpractice, and Residential Construction Defect.

Being injured or hurt in an accident or industrial accident can be a frightening and stressful experience. Here is some basic information about personal injury law as pertains to the State of Georgia.

If you were injured as the result of an accident, you may be entitled to damages. The first thing that you will need to do is to determine the cause of the accident, which will help you to decide on which lawyer is best for you. For example, was it a car or boat accident? Were you injured while riding your bike? Was it a ’slip and fall’ accident? Perhaps you were injured due to malpractice, or perhaps injured by slander or libellous statements. If so, then you most likely will need a Georgia personal injury attorney, who specialises in personal injury law, in the State of Georgia.

Maybe the act was intentional rather than the result of an unintentional act. If so, you may be entitled to punitive damages, as outlined by the laws in Georgia. Examples of this type of injury include assault, defined as reasonable harm that occurred, or battery, which refers to the intentional harming of another person, like hitting or striking. Defamation is an area of personal injury that is often overlooked. This type of assault, if you will, is often the result of hateful or intentionally harmful communication, like verbal or written commentary about you or your character.

Once you’ve decided which type of Georgia personal injury attorney you’ll need for your lawsuit, you need to find one. There are numerous databases available online, to help you with finding a Georgia personal injury attorney, which are designed to help you find the best attorney for your individual case. Likewise, you can also contact your local legal association or state Bar association, which will most likely be happy to provide you with a referral.

Being injured or slandered is never a pleasant experience. If you have suffered because of someone else’s negligence or intentional acts, you may be entitled to damages.

About the author:
Dave Hoffman is the founder of Personal Injury Atorneys a website providing information on personal injury law

Personal injury is termed as damage done to an individual or death as a consequence of an accident that was caused due to neglect of another party. Personal injuries need not be bodily injuries to qualify as personal injuries. Emotional and psychological strife caused due to other persons are also termed as personal injury. Law tries to protect victims who are harmed by the action or inaction of another party and are able to claim compensation for the same.

Victims can file a claim for an injury suffered physically or mentally, and it can also comprise of damage to property. Various online websites offer information about Florida personal injury attorneys. These sites offer online directories that provide details pertaining to fee structure, office staff, and lawyer-client relationship of Florida personal injury attorneys.

Most law firms maintain websites that makes getting in touch with Florida personal injury attorneys quite easy. Individuals may browse through several sites and compare services offered by different law firms. Florida personal injury attorneys online are experienced professional advisers on legal matters relating to personal injuries. They represent victims suffering from such injuries in court and may seek to win compensation for their clients.

Victims suffering from severe personal injuries, physical damage, or emotional anguish must be aware of suitable steps that they need to take in order to protect their legal rights. It is suggested that victims verify credentials of Florida personal injury attorneys online before they choose a lawyer to represent and protect their rights.

Florida personal injury attorneys online generally try to negotiate with the opposite party directly or their insurance company. Some Florida personal injury attorneys online provide free initial consultation, permitting clients to be able to meet with more than one attorney, till they find an attorney that suits their needs. Most Florida personal injury attorneys online charge fees only when clients recover the full money.

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There are various laws governing personal injury cases in South Florida. A competent and reputed lawyer may be employed by a victim to review a personal injury case in South Florida. Though the general practice remains the same, special statutes and laws within the larger concept govern individual states. Personal injury attorneys need to have specific experience and knowledge of relevant laws to get suitable compensation for their clients.

Different kinds of personal injuries, such as dog bite or medical negligence, require attorneys who have substantial knowledge as well as experience in handling such cases. Victims are advised to seek information from personal injury attorneys about cases handled by them that were similar to their injury. This serves as a useful way to find out the manner in which South Florida personal injury attorneys deal with such cases. Victims may also check the credentials and past reputation of that personal injury lawyer to stand a good chance of getting a just compensation for their injuries.

Most personal injury attorneys in South Florida work on a contingency fee basis and do not charge their clients until that suit is effectively resolved in favor of the victim. Personal injury attorneys usually advance legal expenses and are recovered once the case is settled.

Most personal injury attorneys in South Florida may have tie- ups with medical homes. This allows their clients to avail of necessary medical treatment in case of accidents, while the suit is pending in court.

Some medical homes advance their expenditure as well and ask for payment after the lawsuit is successfully settled and victims have received their due compensation. This option is beneficial for victims who do not have health insurance and cannot afford the required treatment.

South Florida personal injury attorneys can be contacted over telephone, online through their websites or by approaching them personally. Some South Florida law firms have a battery of lawyers who specialize in various fields and are available under one roof. These attorneys provide professional consultation immediately.

Florida Personal Injury Attorneys provides detailed information on Florida Personal Injury Attorneys, Florida Personal Injury Claims, Florida Personal Injury Lawsuits, Florida Personal Injury Laws and more. Florida Personal Injury Attorneys is affiliated with Florida Personal Injury Lawyers Info.