Be Aware of Medicare Liens
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When an individual has a personal injury claim arising out of the negligence of another, that claim could be subject to a Medicare lien.
The Medicare lien means that when a recovery is obtained from a third party, the lawyer is legally bound and obligated to pay the Medicare claim from the proceeds of the recovery from the negligent party.
If Medicare pays medical expenses arising out of an injury negligently caused by another person, federal law requires that Medicare be reimbursed for those expenses out of any recovery from the negligent party.
This Medicare lien arises, even in the absence of formal notice to the claimant or their lawyer.
There are some things that a lawyer can do for the injured party to lessen the burden of a Medicare lien.
Our clients sometimes ask whether they should file a Medicare claim to pay medical expenses arising out of an injury caused by the negligence of another. The answer is almost always "yes." This is true even though receiving such benefits from Medicare will result in the lien.
The medical bills covered by Medicare will almost always be significantly reduced. By accepting Medicare payments, a healthcare provider agrees to accept the reduced fees as payment in full. This is a substantial benefit to the claimant since the medical providers could also have a lien against the recovery from the negligent party in the full amount of the original bill.
Another big advantage of filing the Medicare claim is that, in most cases, the providers are paid before payment could be received from a personal injury claim. This fact keeps the medical providers happy and helps assure that medical services will be provided. Not all medical providers accept Medicare patients. Even fewer healthcare providers are willing to postpone payment for their services until a personal injury claim is resolved.
For more information on this subject matter, please refer to our section on Medical Malpractice and Negligent Care.