The MSPRC announced that they are implementing a low dollar threshold of $300.00. If a case meets the criteria outlined below, there will be no recovery by CMS. I presume this is a pre-emptive move by CMS in response to the bi-partisan support the SMART Act (HR 1063) has received to reform the conditional payment recovery process. It is pretty meaningless given the fact that the threshold is $300 total lump sum settlement. Perhaps it is a tiny step in the right direction. I have pasted the text of the alert below. You can also find it by visiting the MSPRC's website.
Beneficiary Alert: $300 Threshold on Liability Settlements
Medicare has implemented a $300 threshold for certain Liability Insurance cases. If all of Medicare's criteria are met, the MSPRC will not recover against the beneficiary's settlement, judgment, award or other payment.
If you're a beneficiary, what does this mean for you?
As of September 6, 2011, if you've received a lump sum settlement of $300 or less, and your case meets certain conditions, Medicare will not recover from that settlement. These conditions include:
- Your settlement is related to an alleged physical trauma-based incident, not an alleged exposure, ingestion, or implantation, and
- You do not have any additional settlements related to the same alleged incident.
Please note that this threshold specifically excludes settlements where an insurer is paying your medicals bills directly or on an ongoing basis. This threshold also does not apply if a demand letter was already issued for your case. We have posted a more detailed explanation in the Attorney and Insurer Toolkits.