Saturday, July 11, 2009

A Little Something For Medicare

Some things are hard to give away, but money has certainly never been in that class, except, apparently, when the recipient is Medicare, and the donor is trying to comply with the law. Hard to believe? I thought so, too, but then I read this McClatchy article.

Usually it's Washington that's trying to squeeze money out of taxpayers. Here's a case of some people trying to pay the government what it's owed, only to learn that Washington doesn't seem to be that interested.

They're personal injury lawyers and they represent Medicare beneficiaries who've been in accidents. Medicare has paid their hospital costs, which must be reimbursed once the victim reaches a damage settlement with the party at fault.

Lawyers in Kansas City and elsewhere, however, said that Medicare can be extremely slow to tell them what its share of the settlement should be, taking several months and as much as a year or more.

That can prevent them from engaging in damage negotiations with the liable party's insurer, or from reaching an agreement and distributing the money if they already have.

As far as I am concerned, Medicare is second only to Social Security when it comes to the best things that have happened to America. Unlike Social Security, however, Medicare needs some additional tweaking, primarily because of the gargantuan rises in health care costs. Fraud has also become a problem, especially with respect to durable medical equipment and prescription medicines (thanks to the 109th Congress), but gradually US attorneys have begun investigating and prosecuting with success.

What the article is talking about, however, is entirely different facet of the program. Attorneys representing Medicare recipients who have been injured in a motor vehicle accident or any other type of accident and who have used Medicare to pay their medical bills until the law suits are resolved are fully aware of the recipients' obligation to repay the government from the proceeds of any award or settlement. If it's a settlement, generally only one check is drafted, deposited in the attorney's trust account, and the outstanding liens are paid before the plaintiff is paid. In order for that to happen, however, the attorney has to know just how much the various liens are. Determining that shouldn't be a problem. Usually a phone call does the trick, but not with Medicare.

And why is that? Well, Medicare has outsourced such collections to a private company (the Chickasaw Nation Industries, Inc.), but apparently hasn't bothered to engage in any training or any oversight with the contractor. As a result, money is being withheld for months for absolutely no good reason. Finally, folks in Washington are beginning to look into the problem, primarily because the money involved is pretty sizable.

Sen. Claire McCaskill, a Missouri Democrat who's the chairman of a subcommittee on contracting oversight, has asked Medicare to explain how its payment recovery program works.

"People are trying to pay Medicare and Medicare is not paying any attention," she said. "Clearly with our health care costs where they are and the amount taxpayers are spending on Medicare, the notion that someone is trying to give them money and no one is home is pretty offensive."

As of March 31, Medicare clients owed the agency $201 million in cases involving secondary insurance payments, [Gerald Walters, director of the financial service group for the Center for Medicare and Medicaid Services] said. It's hard to know how much of that money was, like Bough's $60,000, sitting in an escrow account or a safe in some lawyer's office.
[Emphasis added]

$201 million: that isn't exactly chump change. Maybe the government should get serious about such lapses as part of the "reform health care" drive it ostensibly is on. And then maybe those people waiting for their settlement proceeds so they can get on with their lives won't have to wait so long.

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