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Ed Smith
Ed Smith
Contributor •

Medicare's Reimbursement rights set to expand.

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Beginning January 1, 2006, not only will Medicare require reimbursement for injury-related care, but will expand reimbursement interest to include prescription drugs.

In the past, not only has Medicare taken a bite out of personal injury settlements and awards by requiring reimbursement for costs for medical care provided, but will now allege a separate right of recovery via Prescription Drugs Plans under the new Part D Program. Keep in mind, starting 1/1/06, there will be two separate plans with recovery rights; Medicare and Prescription Drug Plans (PDPs). Not just one.

And that’s not all.

Medicare is also adding the future costs of injury related prescription drug coverage to allocations created for Medicare Set Asides. What that means is, a Medicare Set Aside is not only necessary in a Worker’s Comp settlement involving a Medicare beneficiary, but is advised in personal injury settlements that include a specific and definitive allocation for future medical treatment, particularly future medications.

Medicare’s rights to reimbursement are controversial. Consult with a very expereinced attorney before agreeing to repay Medicare anything.