Understand the Obligations of Plaintiff/Lawyer Related to No-Fault Conditional Payments
Medicare has five different file designations that can be opened by more than eight different settlement types. It’s possible to have each of those open on one case (if that case is a motor vehicle accident where the plaintiff was at work).
So who pays Medicare? And when?
| Settlement/Payment Type | Medicare File Type | Who is “Debtor”? |
| PIP/Med-Pay (Voluntary Pay) | CRC – No-Fault* | Carrier |
| PIP/Med-Pay (via Settlement/Judgment) | BCRC – No-Fault | Plaintiff |
| Work Comp (Voluntary Pay) | CRC – Work Comp* | Carrier |
| Work Comp (via Settlement/Judgment) | BCRC – Work Comp | Plaintiff |
| Liability or Bodily Injury (via Settlement/Judgment) | BCRC – Liability | Plaintiff |
| Underinsured Motorist Coverage (via Settlement/Judgment) | BCRC – Liability | Plaintiff |
| Uninsured Motorist Coverage (via Settlement/Judgment) | BCRC – Liability | Plaintiff |
| Additional Defendant in Liability (via Settlement/Judgment) | BCRC – Liability | Plaintiff |
*Medicare’s CRC may open multiple files for these types of claims.
What is “Debtor” to Medicare?
Medicare considers the debtor the responsible party. Who is Medicare asking to pay it back? The debtor. Medicare is so certain of who it wants to pay it that Medicare will ignore indemnification agreements.
Medicare has two agents?
For the purposes of “Medicare liens,” yes, Medicare has two agents. CMS also is technically involved, but never opens its own files independently. Medicare’s two agents are the Commercial Repayment Center (CRC) and Benefit Coordination and Recovery Contractor (BCRC). CRC handles recovery only from insurance carriers. BCRC handles recovery only from the beneficiary, the plaintiff.
Please join MASSIVE’s COO, Ryan Weiner, Esq. for his presentation at the RISE 7th Annual RISE Medicare Secondary Payer Master Class on February 25 at 9:00 a.m. (EST). Ryan will explain all of Medicare’s files and provide examples of where Medicare will open two, three, or many more Medicare lien recovery files. Register today and use code SPKR15 for 15% off!