The Centers for Medicare and Medicaid Services (CMS) is responsible for ensuring that the Medicare Trust Fund does not pay for medical expenses when another payer is primarily responsible. The Medicare Secondary Payer Statutes give Medicare rights as a secondary payer for both workers’ compensation and personal injury settlements. The employer or insurance carrier is responsible to pay medical expenses prior to settlement, and proceeds from the settlement are to be used properly before Medicare will pay Medicare allowable, injury-related expenses after settlement.

The CMS has recovery rights in instances when it has paid where it should not have. In certain circumstances, the CMS can levy damages or suspend Medicare benefits until the repayment of those funds has been made. By taking steps to consider Medicare’s interests in your settlement, you’re mitigating future potential liability and exposure under federal law