| The Benefits Coordination & Recovery Center (BCRC) is responsible for recovering conditional payments made during the course of a workers’ compensation claim when there is a settlement, judgment, award, or other payment made to the Medicare beneficiary. The Parties, including Beneficiaries and their attorney(s) should recognize the obligation to reimburse Medicare during any settlement negotiations, and determine who will be responsible for paying conditional payments, if any. When there is a settlement, judgment, award, or other payment, the beneficiary, their attorney, carrier, or other representative should notify the BCRC. The BCRC process may also be (and is often) triggered when an MSA is submitted, approved, and the final settlement documents are received by CMS. However, if there is an outstanding conditional payment at the time of settlement that is not addressed in the settlement, the beneficiary may be in for a big surprise. If CMS believes conditional payments exist, and a settlement, judgment, award, or other payment has already occurred when a case is first reported, a Conditional Payment Notification (CPN) will be issued. A CPN will also be issued when the BCRC is notified of settlement, judgment, award, or other payment through an insurer/workers’ compensation entity’s MMSEA Section 111 report. The CPN provides conditional payment information and advises on what actions must be taken. How can an Applicant be proactive regarding conditional payments? Make sure CMS is notified as soon as there is a pending liability, no-fault, or workers’ compensation claimParties may obtain a current conditional payment amount periodically throughout the claim to stay on top of any issuesObtain current conditional payment information at the time of settlementClearly identify body parts admitted under claim in the settlement documents. If needed, a statement that all other body parts/claims are denied. Please consider jurisdictional requirements regarding settlement languageDo you have questions about MSAs, how to value future medical care or posturing your cases for future medical settlement? Contact us for more information! Questions about MSAs, future medical cost projections/life care plans or posturing your cases for future medical settlement? Click here for more information.Stay tuned for Part VI of our MSA Reporting Series – Settling a case before CMS approves a submitted MSANote: The information contained herein was obtained from CMS and Medicare Secondary Payer resources and is not to be considered legal advice. |
| Our step-by-step process to get MSS working for you couldn’t be EASIER: Use our client portal at medicalsettlementspecialists.com to complete a case intake form and upload documents. On our intake form, tell us your settlement goals (for example, understand the medical exposure, help educate your client regarding their potential risks/benefits of settlement, review an MSA for accuracy, identify non-Medicare covered items, review contested body parts that may be related, etc.) Once you receive your draft report, schedule time to learn the best ways to utilize this powerful TOOL we have built for you! |