Personal Injury Settlement of $750 or Less Avoids CMS Liens

Personal Injury Settlement of $750 or Less Avoids CMS Liens

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The Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART Act) requires CMS to set an annual threshold for recovery of conditional payments. For 2020, the threshold remains unchanged from 2019: $750.

This means that settlements of $750 or less do not need to be reported to CMS, and any conditional payments made by CMS for those claims do not need to be repaid.

The same principle should apply to Medicare Advantage Organizations (MAOs) asserting lien rights under the Secondary Payer Act. If they are pursuing recovery under the SPA, they should be bound by the same $750 threshold.

However, no such threshold exists for MAO recovery claims based on state law. So, when a MAO asserts a lien or reimbursement demand, be sure to pin them down on the legal basis for their recovery. Are they proceeding under the federal Secondary Payer Act? Or are they relying on state-specific subrogation or reimbursement rights? The answer matters.

Knowing how to navigate these distinctions can make the difference between a valid obligation and an unenforceable demand.

Explore More Resources with Lien Project Network

For a deeper dive into lien resolution strategies, settlement planning, and reimbursement challenges, explore our educational modules. Lien Project Network serves as a trusted resource for plaintiff attorneys, providing insights on financial planning, public benefits, and structured settlements in the context of lien management.

Need Assistance? Work With The Lien Project, PC

If you need expert legal assistance in navigating lien resolution, reimbursement claims, or settlement planning, our team at The Lien Project, PC is ready to help. As an LPN member, you earn credits that can be applied toward lien reduction and resolution services provided by The Lien Project, PC, allowing you to offset up to $900 per year. Your investment in continuing education through Lien Project Network not only enhances your lien resolution skills but also reduces the cost of engaging legal experts when needed.

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