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Patients in Limbo, While Medicare Sifts Through Paperwork

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While plaintiffs attorneys have always fought to ensure that people have a fair chance to receive justice through the legal system when they’re injured by the negligence and misconduct of others, they also perform another little-known service. When a person whose health care costs are covered by the government’s Medicare program is harmed through medical negligence, plaintiffs attorneys not only help the injured patient receive justice but also help Medicare recoup the costs of that patient’s care.

Unfortunately, inefficiencies in Medicare’s administration have made it much more difficult for attorneys to perform either of these roles. As a recent McClatchy article illustrates, plaintiffs attorneys who have won settlements for their clients are finding it increasingly difficult to work with Medicare to reimburse its expenses. And these break-downs in the system are leaving many patients in an unfortunate and lengthy limbo.

Following a settlement, an attorney whose client is covered by Medicare is required to submit paperwork to the agency in order to determine how much it’s owed. But many attorneys have found that “Medicare can be extremely slow to tell them what its share of the settlement should be” often taking “several months” or “as much as a year or more.” These delays mean that many clients aren’t getting the settlements that they’re owed.

AAJ Director of Regulatory Affairs Gerie Voss, who was interviewed for the McClatchy article, said that “Many consumers who are waiting on money that they deserve are either experiencing a ridiculous level of delay or not even getting money.” Attorney Stephen Bough, who has experienced these frustrations firsthand, said that, “the agony for these families who have to go through this hassle is tragic.”

The problem has become so widespread that even Congress is beginning to take note. Sen. Claire McCaskill (D-MO), who chairs the Senate’s Subcommittee on Contracting Oversight, has demanded that Medicare explain why it is taking so long for the agency to follow-up with patients who are ready and willing to pay. “‘People are trying to pay Medicare and Medicare is not paying any attention,’ she said. ‘Clearly with our health care costs where they are and the amount taxpayers are spending on Medicare, the notion that someone is trying to give them money and no one is home is pretty offensive.’”

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  1. Mike Bryant says:
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    Hopefully, they can make a difference with additional oversight. The present system is inefficient and costs the taxpayer recoveries and delayed payments.