Does the Medicare program have a claim against a lump sum workers compensation payment before an injured partys Medicare entitlement?
A13. No. Medicare cannot make a formal determination until the injured party actually becomes entitled to Medicare. However, once the injured party becomes entitled, Medicare payment may not be made to the extent of Medicare’s interests in the lump sum payment pursuant to ‘ 42 CFR 411.46 or according to a Medicare Set-aside that adequately considers Medicare’s interests. Comment: If a Medicare Set-aside of some sort is not utilized in settlement of workers’ compensation claims then the client’s only recourse is to take an appeal to each Medicare payment denial.
Related Questions
- Where a workers compensation claim settled prior to January 1, 2006, can the injured party use the Medicare Set-aside funds to pay for prescription drug expenses related to the workers= compensation injury?
- Does the Medicare program have a claim against a lump sum workers= compensation payment before an injured party=s Medicare entitlement commences?
- Does the Medicare program have a claim against a lump sum workers compensation payment before an injured partys Medicare entitlement?
