Compliance with Medicare Secondary Payer regulations

Workers’ Compensation Agency (WCA) releases new form to help with Medicare Secondary Payer compliance issues.

Resolving a workers’ compensation case when Medicare is involved can be difficult. Steps must be taken if a person is currently on Medicare to ensure compliance with federal regulations. This includes reimbursement for conditional payments and establishing a Medicare Set-Aside. Ignoring these items could result in a collection action or non-payment of medical.

Applying for SSDI or getting close to retirement age means a person has an expectation of eligibility. He or she must also consider Medicare’s interests. Funding a voluntary Medicare Set-Aside is a tool that can be used for this purpose. This is an account that is created to pay future medical bills.

The WCA has released a new form called Addendum to Agreement to Redeem Liability (WC-556A) to help address potential issues with Medicare, Medicaid, and Friend of the Court. These are considered the “big 3” when it comes to settlement. A magistrate will not approve a settlement unless they are addressed.

Form WC-556A is a departure from previous versions because it makes clear that Medicare’s interests must be considered. This is accomplished by ensuring plaintiff or defendant agree to pay Medicare back for conditional payments. It also allows the parties to show the magistrate how future interests are being considered. This can be accomplished by creating a Medicare Set-Aside to pay future medical treatment. It is also possible to have a doctor certify that a plaintiff is fully recovered and will not need additional medical treatment related to the work injury.

Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 201-9497 for a free consultation today.

Related information:

The Big 3 Liens: Medicare, Medicaid, and Friend of the Court

Photo courtesy of Creative Commons, by PNASH.

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