The Medicare Secondary Payer act (MSP) was enacted on December 5, 1980. Despite being federal law for over thirty-five years, many attorneys still struggle with ensuring their settlements fully comply with the statute’s three basic requirements: ensure Medicare remains secondary to settlement proceeds, reimbursement of Medicare’s conditional payment amount, and report the settlement via the Section 111 reporting requirement. Since 2009, the Centers for Medicare and Medicaid Services (CMS) has methodically stepped up its enforcement of the MSP statute in all liability settlements. The most recent changes to CMS enforcement came in Fall 2017 when CMS took steps to ensure Medicare does not make any accident-related medical payments post-settlement. Further enforcement measures are anticipated by September 2019.
Christine Hummel, Esq.
July 29, 2019
Two Notices of Proposed Rule Making anticipated by September 2019
Section 1: Overview of the Medicare Program and Medicare Secondary Payer Act
Section 2: Section 111 Reporting
Section 3: Medicare’s Conditional Payment
Section 4: The Medicare Set Aside (future medical allocation)