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Congress Reverses Medicare Payment Cuts

Last Thursday, the House voted 417-1 to reverse cuts for Medicare payments to doctors.  The Senate had already voted the same a week earlier.  According to CNN Money, the move will cost the federal treasury nearly $6.4 billion over ten years.  These cuts have been blocked four times since January.

In terms of Medicare liens and the effect on Medicare lien resolution, this means that the MSPRC, COBC, and CMS will continue to increase their liens.  They will continue to make final lien demands which far exceed fair amounts.  In reality, this changes nothing.  However, it shows a need for the federal government to continue its aggressive reacquisition of Medicare funds.

This means that you have to be careful when reviewing Medicare liens.  Do not take the MSPRC’s word for it.  Its job is to limit Medicare losses.  How can you be more careful?

1.  Report to the COBC early.  It now takes more than 65 days for the MSPRC to prepare a Conditional Payment Letter – and that’s only after the COBC transfers a file to the MSPRC.  Expect 80 days between your reporting and the MSPRC sending you a Conditional Payment Letter.

2.  Review ALL ICD-9 codes in the Conditional Payment Letter.  At Lien Resolution Services, we rarely see a Conditional Payment Letter where all payments are related to the case.  Review all codes.

3.  Dispute ICD-9 codes in the Conditional Payment Letter.  A good dispute should take you more than a few hours, but it is well worth it to your client.  If a dispute fails, simply try again.  Rewrite the dispute – spend the time to do it well.  This extra time spent working against the MSPRC will lower the lien.

4.  Report your costs and fee information to the MSPRC.  This information is the key to the MSPRC/Medicare Procurement Formula.   More importantly, it will lower the lien by at least 33 percent, if not more.

5.  Dispute, appeal, and offer compromises to the MSPRC and CMS until the lien is reduced.

These processes take time and effort.  If you don’t have that time, get help with Medicare liens. The process is the same for all healthcare liens, so you should get lien resolution assistance in all situations.  If you want LRS’s help with lien resolution, contact us for information on our flat-rate fees.

Ryan J. Weiner
Co-Founder Lien Resolution Services
This Blog/Web Site is made available by the publisher for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog site you understand that there is no attorney client relationship between you and the Blog/Web Site publisher. The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.

About Ryan J. Weiner

Co-Founder of Lien Resolution Services, LLC, a national healthcare lien resolution firm. Our goal is to assist in the fair administration and resolution of healthcare liens on personal injury cases. Please visit our website for more information: www.lienresolutionusa.com.

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