Medicare Conditional Payment and Medicare Advantage Plan Reconciliation Processes

To maximize their clients' recovery after a personal injury settlement, personal injury counsel must understand the Medicare Secondary Payer Act's conditional payment reconciliation process. This process involves a series of prescribed steps: completing required forms, producing settlement documentation, and following a strict appeal process.

Medicare Advantage plans, administered by private insurance companies, use the Medicare Secondary Payer Act as their recovery vehicle. Though Medicare Advantage plans arguably have the same recovery rights as traditional Medicare, they are often much more open to agreements based on equity and fairness. Counsel also need to understand the reconciliation process for these plans.

Listen as our distinguished panel explains the process for obtaining Medicare refunds for plaintiffs following a personal injury settlement via the Medicare conditional payment and Medicare Advantage plan reconciliation processes.