Missouri Injury Law Blog

As a St Louis injury lawyer, I believe it is important to clarify, with my personal injury clients, the rights Medicare may have against their injury claim. A crucial issue when settling a personal injury case, that many people may not realize, is payback to Medicare or the requirement of Medicare Set Aside if the injured client is a medicare recipient or is expected to receive medicare benefits in the near future. Medicare demands a set aside of money to cover future medical costs medicare may have to payout in the future as a result of the injury caused by a negligent party.

The extent Medicare can recover or demand a set aside is often litigated. For example, a recent decision clarified Medicare has no recovery rights in Missouri wrongful death claims. St Louis Injury Lawyer Blog re: Medicare Recovery of Wrongful Death Benefits, discussing the Bradley v Sebelius case.

Another recent decision was fought by personal injury attorneys against medicare and the decision has affects for my injury clients in St Louis and across Missouri and Illinois. The court in Haro v. Sebelius determined Medicare was overreaching and found no statutory authority to support a direct action against a personal injury victim's attorney, except to the extent they are recipients of settlement proceeds. The court acknowledged the obvious: Medicare is putting personal injury lawyers in a quandary with their clients that is not supported by the statute. Thus medicare cannot hold settlements hostage by requiring personal injury attorneys to either turn the settlement money over to Medicare or hold the settlement money in trust while the lien is being disputed.

Now it appears the contractors that handle the Medicare recovery of injury awards have suspended issuing rights and responsibly letters and demand letters for payment. MAybe while they try to go through congress to get around the Haro decision. This causes problems for injury lawyers as we cannot issue our client's funds before Medicare liability is determined. In fact, in most cases the insurance company for the negligent party (ie. driver that causes a car accident) refuse to issue settlement checks without written confirmation from the Medicate contractor about their lien.

Currently, I am handling a St Louis nursing home injury case, the nursing home is ready to settle, however, Medicare has not informed me of what they are claiming is the Medicare lien against any recovery. The nursing home's insurance company is not going to issue the settlement check because they could be liable if the liens are not satisfied. The problem is, it take several months for Medicare to tell you what their lien is! Thus holding hostage the settlement for any client that is a medicare recipient, mainly the elderly.