6-7-2011; Medicare Set-Aside Specialist Shawn R. Biery reports more items of interest with regard to Medicare and the ongoing changes which appear to be in response to a Federal District Court...

As previously reported, Medicare had suspended issuance of several letters usually provided with regard to injury litigation which might impact or be subject to future medical or repayment issues with regard to Medicare. At last check, issuance of the Demand letters is still temporarily suspended however review of the Rights and Responsibilities letter (“RAR”) is complete. Issuance of the RAR is anticipated to resume on June 10, 2011. A copy of the revised RAR is supposed to be made available by that time and we will report when we have a copy.

As previously reported, the Demand letter for liability insurance (including self-insurance), no-fault insurance and workers’ compensation is still temporarily suspended while that letter is under review. We again confirm the MSPRC is still working cases, and Demand letters will be mailed out once that review is complete. We believe this is a likely impact due to the decision in Haro v. Sebelius (CV 09-134 TUC DCB Fed. D. Az.), which essentially enjoined Medicare from requiring payment of a conditional payment demand pending a Medicare beneficiary’s request for appeal or waiver of a conditional payment as it was found that the current procedure (collecting interest pre-resolution) exceeds CMS’ authority under the MSP statute and also enjoined Medicare from seeking direct recovery for conditional payment funds from Plaintiff attorneys and indicated “There is no statutory authority, expressed or implied, to support a direct action against attorneys, except to the extent that they are end-point recipients of settlement proceeds.”

We will continue to report as updates are provided from CMS. Please feel free to contact Shawn R. Biery, J.D., M.S.S.C. at sbiery@keefe-law.com with any questions regarding Medicare Set-Aside issues. Feel free to post them on our blog at: http://keefe-law.com/kcablog.html