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

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

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Conducted on Wednesday, July 27, 2022

Recorded event now available

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Course Materials

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.

Description

When personal injury plaintiffs accept Medicare or Medicaid 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 their 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 course 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 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.

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Outline

  1. Using the Medicare Portal
  2. Appeals
    1. Redeterminations by a Medicare Administrative Contractor
    2. Reconsiderations by a Qualified Independent Contractor
    3. ALJ appeals to the Office of Medicare Hearings and Appeals
    4. Medicare Appeals Council appeals
    5. District Court

Benefits

The panel will review these and other pivotal issues:

  • When using the Medicare Portal, what mistakes cannot be corrected?
  • What are the most common types of mistakes Medicare makes when issuing a final demand?
  • Is the Portal form and AI driven?
  • What types of appeals are most likely to succeed?
  • How soon should appeals be made?
  • Who decides appeals?

Faculty

Cattie, John
John V. Cattie, Jr.

Founding Member
Cattie & Gonzalez

Mr. Cattie focuses his law practice exclusively on MSP and MSA issues, providing legal opinions regarding reporting and...  |  Read More

Place, David
David L. (Dave) Place, JD

Owner
The Place Firm

Mr. Place exclusively assists personal injury victims and plaintiff counsel with complex lien resolution problems using...  |  Read More

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