Making Medicare’s Automatic Reductions Automatic

Medicare lien resolution can be a headache for many law firms; but if you know its rules, you can take advantage of some helpful regulations.

For example, many lawyers ask us about Medicare’s automatic reductions. Here’s the thing: They’re only automatic if you give Medicare what it needs to calculate the reductions.

Medicare’s reductions are governed by 42 CFR 411.37, which states:

“(c) Medicare payments are less than the judgment or settlement amount. If Medicare payments are less than the judgment or settlement amount, the recovery is computed as follows:

1. Determine the ratio of the procurement costs to the total judgment or settlement payment.
2. Apply the ratio to the Medicare payment. The product is the Medicare share of procurement costs.
3. Subtract the Medicare share of procurement costs from the Medicare payments. The remainder is the Medicare recovery amount.”

If you’re having trouble understanding that regulation you’re not alone.

If you need help reducing Medicare liens consider utilizing an expert service. For help with Medicare Liens, Medicaid Liens and any other Health Insurance Lien , please contact us at (833) GO-MASSIVE or (833) 466-2774.