Pursuant to 42 USC Section 1395y(b)(2), commonly known as the Medicare Secondary Payer Act, Medicare may not make payment for medical benefits where ôpayment has been made or can reasonably be expected to be made under a workmenÆs compensation law or plan of the United States or a state or under an automobile or liability insurance policy or plan (including a self-insured plan) or under no fault insurance.ö By law, Medicare has a priority right of recovery from the primary payer as well as from parties in receipt of third-party payments, such as a beneficiary, provider, supplier, physician, attorney, state agency or private insurer (42 CFR 411.24(g)). Accordingly, it is essential that all parties to personal injury insurance settlements ensure that MedicareÆs interests are protected and therefore of the utmost importance for all attorneys, insurance company personnel and medical billing professionals to fully understand how and when the MSP applies in any given personal injury situation. You will benefit from an overview of all pertinent statutes and regulations, as well as CMS interpretation in its manuals and policies. WeÆll address individual areas of law separately as to the manner in which the MSP applies in each. Most significantly, youÆll learn about workersÆ compensation settlements, as CMS is most actively monitoring them and has established policies with respect to addressing past and future medical expenses in the settlement of claims. WeÆll address liability settlements as a hot topic since there is no established CMS guidance as there is in workersÆ compensation, yet itÆs rumored to be CMSÆ next target. YouÆll walk away with valuable insight and a better understanding of MedicareÆs role in insurance claims settlement.

Faculty: Jennifer C. Jordan, Medval, LLC