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Birmingham Bar Association Bulletin - Fall 2014

1. Lien Requests Effective October 1, 2013, CMS will have 65 days from receipt of a request for the Medicare lien amount; however, the time period may be extended 30 days after additional notice is provided. After that period, the parties can rely on the reimbursement amount available through the online portal. The importance of this provision is that it would require CMS to provide a final lien demand prior to a settlement of the claim. There is also a provision that reporting entities do not have to access or report social security numbers or Medicare ID/health identifications numbers. 2. Civil Penalties Effective March 10, 2013, the civil penalties for non-compliance with mandatory insurance reporting requirements will no longer be mandatory; rather, the language would be changed to read “may be subject to a civil money penalty of up to $1,000.00 for each day of noncompliance with respect to each claimant.” CMS is to solicit proposals from insurance professionals as to how to apply the fines and outline specific practices (e.g., explore the carrier that has made good faith efforts versus the carrier that has ignored all efforts to comply). 3. Statute of Limitations Effective July 14, 2013, there will be a three-year statute of limitations for Medicare Secondary Payor recovery actions from receipt of the Section 111 report. 4. Right of Appeal CMS released a proposed rule in late December 2013 that is intended to implement certain provisions of the SMART Act by requiring a right of appeal and an appeal process for liability insurance, Medicare Law no-fault insurance and workers’ compensation plans when Medicare pursues a MSP recovery claim directly from the insurance or workers’ compensation carrier/plan. The proposed rule would allow insurers access to the current appeal process, rather than beneficiaries only. Overall, the reporting and reimbursement requirements initially promulgated by CMS have put a definite kink in the handling of liability cases. CMS is acknowledging some of those issues by providing relief in the form of minimum thresholds and self-calculating options - better late than never. It is important, however, for businesses, insurers and attorneys to keep monitoring the MSPRC website (http://cms.gov/) for updates, as they are posted without warning or fanfare. Keeping current with these evolving laws will not only ensure that your client is not penalized, there are money-saving options of which both plaintiffs and defendants or insurers may take advantage. G “Often, your clients are at Point A, and want to go to Point B. We can help them get there. “Sometimes they are at Point A and will be taken to Point B, like it or not. In that case, we make the journey less painful.” Stephen Bradley, Principal Whether it’s an emerging crisis that demands deft media and communication skills, or simply a thorny political or regulatory challenge, we’re in business to help your clients navigate from the place they find themselves to the place they want to be. Stephen Bradley & Associates is Alabama’s first—and best—full service public affairs firm. Our highly specialized team combines the management of demanding public relations issues with expertise in governmental and legislative affairs. So, when you or your clients need help with crisis issues management, media relations, environmental issues, or governmental affairs, we’re the firm to turn to. With offices in Birmingham and Montgomery, our experienced team has the tools, the experience, and the know-how to help. Call or email us today, and let us help you put your client on the road to where they need to be. S B A, LLC Public Relations • Media Relations • Crisis Communications • Environmental Communications • Governmental Relations • Social Media 2101 Highland Avenue, Suite 420, Birmingham, AL | 205-933-6676 • 400 South Union Street, Suite 235, Montgomery, AL | 334-834-9685 To learn more, visit PRalabama.com. Or, email us at ebrad@bellsouth.net Birmingham Bar Bulletin/ Fall 2014 25


Birmingham Bar Association Bulletin - Fall 2014
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