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.

I. Navigating the Medicare conditional payment reconciliation process

II. Expedited resolution techniques utilizing the MSPRP

III. Reconciling payments under Medicare Advantage plans

VI. Attorney liability and best practices

V. Obtaining Medicare refunds post-settlement

The panel will review these and other relevant issues:

• The forms clients must sign to allow their personal injury attorney access to their Medicare information
• Information to include in the claim notice
• How to navigate the Medicare Secondary Payer recovery portal
• How Medicare conditional payments are calculated
• How to submit a hardship letter to CMS when seeking a waiver or compromise of Medicare interest