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HoganWillig Blog

Posts from January 2008.
January 22, 2008

When the time comes to settle a personal injury suit, litigants should be aware that Medicare may have a potential lien against the settlement proceeds in instances where Medicare has made past, conditional payments for medical expenses. This is due a federal law which deems Medicare to be a so-called “secondary payor” with regard to payments made under workers’ compensation, automobile, or liability insurance policies or plans, or uninsured or underinsured coverage. Congress intended Medicare to be the payment source of last resort for medical care; therefore, if a recipient is entitled to receive compensation for his injuries from a “primary payor,” Medicare will not be responsible for the costs. The “primary payor,” in many personal injury actions, is the defendant’s liability carrier. Medicare will make payments, however, if the primary payor cannot be reasonably expected to pay promptly for the medical care. These payments are called conditional payments. Medicare conditions these payments on its right to receive reimbursement from the primary payor and from anyone who receives payment from them, including a settling plaintiff.




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