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Exploring Different Processes for Medicare Liens: Parts A, B, C, and D

March 30, 2023
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Medicare written on Chalkboard in white chalk with a red stethoscope resting on top of the chalkboard on the right side

P. Czuprynski

Earlier in March, as part of our complimentary knowledge series of webinars on Medicare Secondary Payer Compliance, we reviewed the different search and collection processes for Medicare Parts A, B, C and D.

During the presentation we highlighted the following key points:

    • The processes require proactive actions by carrier/self-insureds and claimants.
    • Due to the PAID Act, which requires that CMS provide Medicare Part C and D information, querying must be ongoing to identify if a claimant has other Medicare coverage. PAID Act information is available through the process of obtaining updated “HEW” software. Failure to utilize this updated software can lead to unresolved liens and unexpected penalties and fees.
    • Carrier/self-insureds and plaintiffs (or their attorneys) should have workflows in place to confirm Medicare liens are investigated prior to settlement and that a designated plan is in place for resolution post settlement.
    • If ongoing responsibility for medicals is indicated, carrier/self-insureds should have workflows in place to notify Medicare plans and resolve liens as necessary. While traditional Medicare has an automated process for search and collection through the Commercial Repayment Center, Part C and D Plans do not.

Failure to resolve Medicare liens can result in involuntary collection by the U.S. Treasury, double damages, and litigation costs. Collection firms are looking for situations where liens are unresolved and filing a suit for double damages is possible. Understanding and creating workflows for these liens will minimize your organization’s exposure to these risks.

Moreover, with Civil Money Penalties (CMPs) for Section 111 Reporting still pending, now is the time to implement these processes and workflows.

If you would like a link to the recorded webinar, have any questions, or wish to discuss reviewing the workflows needed to effectively identify and resolve Medicare liens, please contact us at [email protected].