Home > Legislation, News > Congress to the Rescue on Medicare

Congress to the Rescue on Medicare

Roberto Ceniceros, of Business Insurance has an interesting article on an issue that quickly became one of the more frustrating parts of California Workers’ Compensation practice.  The conflicts between employees and insurance companies, or the employee’s self-insured employers, can be heated and difficult, but that’s the nature of the game.  The frustration comes in when the parties have agreed and want to settle, but Medicare tells them they can’t.

This was the subject of an earlier post, but the efforts to change this system are the subject of Mr. Cenicero’s articleH.R. 1063 sponsored by (former) Congressman Tim Murphy, the bill is now referred to the House Subcommittee on Health, and would limit the amount of time CMS could respond to a request for Medicare Set-Aside approval.

Presently CMS will not respond to a request for approval of a settlement amount $25,000 or less if the applicant is a current Medicare beneficiary or will enroll in Medicare within the next 30 months and the settlement amount is over $250,000.  The CMS explanation may be read here.

As the saying goes, if wishes were fishes, we’d all be full (except, of course, those of us who do not eat fish).  That being said, both sides of the ongoing struggle of California Workers’ Compensation can wish for H.R. 1063 to eventually see the President’s signature.  For those who need a brush-up on how this process works:

Categories: Legislation, News
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