How often do you do a Medicare set aside? I’ve talked with PI attorneys who never do them and don’t even know what I’m taking about but I’m kind of freaked out bc CMS will come after the attorney if there should be one and you didn’t set it up. Is it hard to do, or do you use someone to set this up?

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Tell them you can’t release payment until you have a lien letter from CMS. Adjuster require them. It’s very common request for settlement. Judges also know this holds up filing dismissal of cases when settled.

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It’s not necessarily hard, it’s just time consuming and can be a bit confusing. When I was going through it the first time, I called their help line and one of the reps literally walked me through each step of opening a new case for a client of mine and everything I’d need to do in the future. Here is the number I called - (646) 458-6740; hope this helps!

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Do you mean putting Medicare on notice of the claim? If so, this is very important. If the case resolves and Medicare finds out/they weren’t paid, not only is the attorney on the hook for the full lien, but I believe there are penalties imposed as well

That can come back to bite them if the client eventually needs more treatment post-settlement and there’s no set aside. While Medicare has been kind of lazy about it, they have been going after attorneys who don’t do this more. The bottom line is if your client has injuries related to the accident that will require future treatment and they’re on Medicare, you need a set aside.

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When we sign a Medicare recipient, we automatically open a case with medicare. This prevents future headaches.

When I get a case, I always ask the client if they have Medicare. I use the CMS portal. They either already have a case set up and I just have to upload the proof or rep, or I set it up on the site.

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