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AAJ President Praises New Guidance on Medicare Secondary Payer Program

Everyone involved with personal injury claims knows that dealing with Medicare has become a nightmare over the past several years. Without going into detail, following the convoluted process required by Medicare in order to get a verified amount owed (or a statement that nothing is owed) takes months after a settlement is made with the insurance company. That means the claimants have to wait all that time before they can get their settlement money. This frequently works an undue hardship on the claimants.

That’s why this story is potentially very good news for claimants, plaintiff lawyers, insurance companies, and insurance company lawyers. We all need relief.

Inside Health Policy reports that trial lawyers and other stakeholders are hailing recent guidance from the Centers for Medicare and Medicaid Services on a program for repaying Medicare for medical services following a third-party settlement, saying that it will help streamline the process. The Medicare Secondary Payer (MSP) program “will now allow beneficiaries with claims under $25,000 to self-calculate the amount owed, after which Medicare would send a final demand letter within 60 days that would be considered accurate for 60 days, according to the trial lawyers association, which supports the new guidance.” American Association for Justice President Gary Paul called the new CMS guidance “a ‘win, win’ for seniors, businesses, insurance companies and taxpayers,” adding that the “current system is riddled with inefficiency, costing taxpayers and businesses millions of dollars each year. Assuming CMS expands the program above the $25,000 threshold, this guidance will go a long way towards addressing these concerns.” Noting that further information is expected to be released by January 15, the account adds that CMS “has also said that it intends to extend the claims threshold beyond $25,000, which the American Association of Justice also strongly supports.” Lawyers USA also quotes the AAJ president in reporting the story.

From the American Association for Justice press release.

Bob Kraft

I am a Dallas, Texas lawyer who has had the privilege of helping thousands of clients since 1971 in the areas of Personal Injury law and Social Security Disability.

About This Blog

The title of this blog reflects my attitude toward those government agencies and insurance companies that routinely mistreat injured or disabled people. As a Dallas, Texas lawyer, I've spent more than 45 years trying to help those poor folk, and I have been frustrated daily by the actions of the people on the other side of their claims. (Sorry if I offended you...)

If you find this type of information interesting or helpful, please visit my law firm's main website at You will find many more articles and links. Thank you for your time.

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