Description

This program examines Medicare-related issues that may affect the valuation, negotiation, and resolution of personal injury and catastrophic injury claims.

The program addresses the legal and practical framework governing Medicare and Medicare Advantage reimbursement claims, including statutory and case law limitations, repayment obligations, and procedures used to identify, evaluate, and resolve conditional payment issues.

It also reviews the Medicare Secondary Payer Private Cause of Action and its relevance to litigation strategy where Medicare-covered expenses are implicated.

The program continues by analyzing the treatment of Medicare Set-Asides in liability settlements, including circumstances in which such arrangements may be proposed, whether submission to Medicare may be required, and the potential effect of allocation methodologies that may unnecessarily reduce settlement value.

Upon program completion (available for CLE credit), participants will be better prepared to distinguish legal requirements from informal practices, assess future medical exposure in the settlement context, and evaluate strategies intended to protect client interests while minimizing post-settlement compliance and administration 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.

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: Insurance Law|Personal Injury​​
TAGS: Insurance|Insurance Claims Recovery|Liability Claims|Life & Health|Negligence|Personal Injury

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