Medicare Liens: Obtaining and Appealing Medicare Final Demands; Navigating the Five Levels of Medicare Appeals

This CLE course will provide personal injury counsel for both plaintiffs and defendants, as well as adjusters, with practical tips and considerations for obtaining a final demand using the Medicare portal and for appealing a post-final demand.

When personal injury plaintiffs accept Medicare benefits to cover accident-related bills, they are obligated to pay back the government if a third party later takes responsibility for causing the underlying injuries, as demonstrated by a settlement, judgment, or another award. Medicare is usually entitled to reimbursement of its expenditures on accident-related medical care.

The Medicare beneficiary must first obtain a "final demand" using the Medicare "Portal." The panel will review this complicated and confusing process and offer tips for navigating it correctly. The final demand can be challenged through an appeals process.

The Medicare appeals process is a multi-step process entered into once Medicare has issued its final demand or amount owed to the Medicare program. The process is different for different Medicare Parts and has five different levels culminating at the district court. Each level has strict time limits, forms, and processes. Failure at any level cuts off further review.

Listen as this esteemed panel guides counsel through how to use the Medicare Portal correctly and then through the appeals process.