Threshold Dollar Amount For Reporting Settlements to Medicare Drops To $2,000; CMS Issues New User Guide


The threshold dollar amount for when private and public employers and insurers are required to report payments to Medicare enrollees pursuant to settlements and judgments has been lowered from $5,000 to $2,000, and will decrease again to $300 on October 1, 2015. As we have reported previously, Medicare requires reporting of any settlement with a Medicare enrollee which contains a general release of all claims, including employment settlements and severance agreements, even if there are no claimed medical expenses or damages.  The penalty for failing to timely report can be $1,000 per day per claim, and for most employers, the payment must be reported online within 45 days of the settlement or severance.  For more information about registering for online reporting and about the reporting obligation, please visit CMS’s website.  For employers who have already registered for online reporting, please note that CMS issued a new user guide this month which includes minor changes with respect to reporting settlements in employment cases and severance agreements.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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