Your feedback to the Centers for Medicare and Medicaid Services (CMS) is crucial.
Send CMS brief, specific examples of how new reimbursement requirements for future medicals will negatively impact your clients. Send your information using this form. Here is an example of information to include:
Client Smith, a Medicare beneficiary, was injured in auto accident with debilitating orthopedic injuries and the potential need for surgery sometime in the future. Client Smith received $30,000 in medical expenses prior to settlement and the life care plan for future medical expenses is $200,000. John Driver has liability insurance with policy limits of $100,000. Client Smith settled the claim for $100,000. In this scenario, if new regulations regarding future medicals in liability cases are in place, Client Smith would see absolutely no benefit from bringing a claim:
$100,000 (settlement), minus $33,000 (for attorney fee), minus $5,000 (costs), minus $18,000 (for past medicals minus some procurement costs, i.e., fees), minus $200,000 (for future medical expenses), equals NEGATIVE $156,000.
Meaning, if the proposed regulations are in place, injured clients would have no settlement money left to access.
AAJ is reviewing the proposal and will provide feedback to CMS by August 14. CMS’s authority in this area is not well established and AAJ will oppose a rule that imposes burdensome and unworkable requirements. AAJ will continue to work to improve the MSP reimbursement process in all areas.