Secondary Payor Requirements May Impact Settlements/Williams Kastner Labor & Employment Advisor

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In the waning days of 2007, with the cost of health care continually escalating and with more and more of the costs being borne by the United States Government, Congress passed and President Bush signed into law the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA). With the stroke of his pen, the President created a responsibility for self insured organizations, liability insurers, group health plans and non-group health plans that pay bodily injury claims to insure that the Medicare system is protected from bearing the costs of current and future medical expenses if those expenses are the primary responsibility of an entity other than Medicare. Entities making such payments are known as RREs. In order to fulfill their responsibility, for each recipient of payments, RREs are required to make a determination as to whether the individual is a Medicare recipient and report any and all payments to the Center for Medicare and Medicaid Services (the CMS) for a determination of the subrogation rights as of that date. In order to ensure that there is an accurate determination of the subrogation rights, it will be imperative that all RREs obtain a social security number of the payment recipient and use that social security number in its reporting.

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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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