Medicare Set-Asides in Catastrophic Injury Cases

Understanding Medicare Obligations

Medicare issues can affect the value and resolution of personal injury claims. Therefore, counsel must identify potential obligations early, especially in catastrophic injury cases.

Resolving Reimbursement Claims

First, the program explains Medicare and Medicare Advantage reimbursement claims. It reviews repayment duties, legal limitations, and conditional payment procedures. Participants will learn how to identify, evaluate, and resolve these claims.

Evaluating Litigation Risks

Next, the discussion addresses the Medicare Secondary Payer Private Cause of Action. This provision may influence litigation strategy when a claim includes Medicare-covered expenses.

Assessing Medicare Set-Asides

The program also examines Medicare Set-Asides in liability settlements. Specifically, it considers when parties may propose an arrangement and whether Medicare review is required. In addition, participants will explore allocation methods that may unnecessarily reduce settlement value.

Applying Settlement Strategies

After completing this CLE program, participants will better understand Medicare's legal requirements. They will also learn to assess future medical expenses, protect client interests, and reduce post-settlement compliance concerns.

Brett Newman graduated with a degree in economics from Syracuse University in 1989. As Managing Partner of The Newman Structured Settlement Group, Mr. Newman is known nationally by attorneys for his expertise in providing comprehensive settlement services. Those services include Structured Settlements, Lien Resolution, Medicare Set-aside calculation and Administration, Special Needs Trust Administration, and Government Benefit Preservation.

A graduate of Rutgers University School of Law at Camden, Franklin Solomon is based in Voorhees, NJ, with a practice focused on evaluation, litigation and resolution of healthcare lien/reimbursement claims. Mr. Solomon represents personal injury victims and their attorneys in defending against claims by health plans and government benefits programs for payment out of tort recoveries.

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Key Learning Objectives:

Examine the legal and practical considerations governing Medicare and Medicare Advantage reimbursement claims in personal injury matters.
Analyze statutory and case law limitations affecting reimbursement rights and potential liability.
Evaluate the potential use of the Medicare Secondary Payer Private Cause of Action in litigation strategy.
Assess the circumstances under which Medicare Set-Asides may or may not be appropriate in liability settlements.
Distinguish between circumstances in which submission of a Medicare Set-Aside to Medicare may be required and those in which it may be discretionary or unnecessary.
Evaluate settlement planning considerations in catastrophic injury matters involving future medical exposure.
Identify risks associated with over-allocation, unnecessary submission, and post-settlement administration practices that may adversely affect client recovery.

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FILED UNDER: Personal Injury & Negligence
TAGS: Lien Resolution|Regulatory Enforcement|Settlements

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Presenters

Brett NewmanCEO, Newman Settlement Services Group

Franklin SolomonFounder, Solomon Law Firm

Tom HagyEditor-in-Chief