Medicare in Personal Injury Claims: Conditional Payments and Medicare Advantage Plan Reconciliation Processes

Techniques to Minimize Repayment Obligations and Maximize Medicare Refunds After a Liability Settlement

Recording of a 90-minute CLE webinar with Q&A

Conducted on Tuesday, January 8, 2019

Recorded event now available

or call 1-800-926-7926
Program Materials

This CLE webinar will guide personal injury attorneys in navigating the complex processes for reconciling Medicare conditional payments and Medicare Advantage plans to increase a plaintiff's recovery following a personal injury settlement.


Personal injury counsel must understand the intricacies of the Medicare Secondary Payer Act conditional payment reconciliation process to maximize their clients' recovery after a personal injury settlement. This process involves a series of prescribed steps, including the completion of required forms, production of settlement documentation and a strict appeal process.

Medicare Advantage plans, administered by private insurance companies, use the Medicare Secondary Payer Act as their recovery vehicle. Though Medicare Advantage plans arguably have the same recovery rights as traditional Medicare, they are often much more open to agreements based on equity and fairness. Counsel also need to understand the reconciliation process for these plans.

Listen as our distinguished panel explains the process for obtaining Medicare refunds for plaintiffs following a personal injury settlement via the Medicare conditional payment and Medicare Advantage plan reconciliation processes.



  1. Navigating the Medicare conditional payment reconciliation process
  2. Expedited resolution techniques utilizing the MSPRP
  3. Reconciling payments under Medicare Advantage plans
  4. Attorney liability and best practices
  5. Obtaining Medicare refunds post-settlement


The panel will review these and other relevant issues:

  • The forms clients must sign to allow their personal injury attorney access to their Medicare information
  • Information to include in the claim notice
  • How to navigate the Medicare Secondary Payer recovery portal
  • How Medicare conditional payments are calculated
  • How to submit a hardship letter to CMS when seeking a waiver or compromise of Medicare interest


David L. Place, JD
David L. Place, JD

Vice President, Director of Lien Resolution Services
Synergy Settlement Services

Vice President of Synergy Settlement Services, Director of Synergy Lien Resolution Services and Multi Claimant...  |  Read More

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