Medicare Lien Subrogation Amount Question

Question: I have a case that is in suit and nearing settlement, but we have been having trouble convincing Medicare to remove unrelated medical charges from its claimed subrogation amount. Has anyone had success with bringing Medicare into the suit to defend its lien? Should we move to amend the complaint to add Medicare as an Involuntary Plaintff or use some other procedure? Does anyone have such a motion they would be willing to share?

Ohio Attorney

Answer: If the claims in question include injury-related diagnosis codes but the date of service was primarily for the treatment of other unrelated conditions, then you will need to send in medical documentation to support your position (doctor notes/or letter, admission/discharge summary etc.) and request to remove the claims. If you provide documentation to get the claims removed and the MSPRC still doesn't remove the claims, the next move would be to go directly to the appropriate Regional Office for assistance. You will have better luck with that approach then bringing Medicare into the suit.