Asbestos cases present a complex challenge from a health care lien resolution perspective. A good asbestos attorney needs to do careful work to ensure that lien obligations are accurately assessed and completed.
A reputable asbestos attorney, like those at our sponsor Kazan Law, takes responsibility for making sure that you do not get stuck using your settlement to pay medical bills that have been inflated in anticipation of a settlement claim. When they obtain large settlements for clients, they don’t stop there. They also see to it that you get to keep as much of it as possible by carefully examining insurance and Medicare itemized claims and medical bills, and negotiating appropriate deductions for the value of their efforts in collecting the funds so that you could end up paying less than half of the claimed amount.
Section 111 of the Medicare, Medicaid and SCHIP Extension Act (MMSEA) was enacted in 2009 and took effect in 2010, significantly changing healthcare lien obligations. The MMSEA, requires reporting to Medicare about settlements involving Medicare beneficiaries. When it comes to Medicare reporting, the key to avoiding problems is to start early and get all the information right.
Failing to address Medicare, Medicaid, private health insurance and other healthcare lien obligations could have negative consequences. You could lose eligibility for government assistance or healthcare coverage, or become the subject of a lien recovery action. Avoiding that is part of what a good asbestos attorney does.
An asbestos attorney must evaluate the following in each case:
- Does the health plan call for reimbursement for past as well as future injury-related care?
- Given the nature of the claimant’s recovery, is full reimbursement appropriate?
- What defenses, compromises, waivers or offsets are available?
When and how you were exposed to asbestos also determines which cases warrant a Medicare report and / or resolution. Effective December 5, 1980, the Medicare Secondary Payer (MSP) liability provisions established Medicare’s reimbursement right in asbestos cases. Medicare does not expect to be reimbursed from asbestos liability settlements if the exposure ended prior to December 5, 1980. In cases where a claimant was exposed to asbestos after that date, Medicare could have a recovery claim. But because of the many decades it takes for symptoms to emerge for asbestos-caused diseases like mesothelioma, most cases involve exposure prior to 1980.
In sum, if you are coping with mesothelioma; you have enough on your plate. Your asbestos attorney should be the one who:
- Determines the obligation to notify healthcare plans
- Assesses the healthcare plan’s right of recovery
- Reviews all reimbursement claims to identify unrelated items
- Pursues relevant administrative or legal remedies