This morning, workers’ compensation attorney Jon Gelman published an interesting note on his blog about a recent Medicare recovery case filed here in Alabama. The case involves the United States seeking to recover medical payments made by Medicare on behalf of several injured individuals.
This Alabama Medicare case raises an often misunderstood and complicated issue we must handle on a daily basis. Most injury victims have some type of health coverage that pays their medical bills. For many, coverage is provided by private insurance like Blue Cross. For others, government programs provide coverage. These government programs include Medicare, Medicaid, Tricare or the Veterans’ Administration. When we seek medical care, our particular coverage provides some level of payment. Each plan or program possesses unique rights to be reimbursed for their payments if an injured individual recovers compensation from some third party. So, you need to deal with these issues in your personal injury lawsuit.
Many personal injury attorneys seem concerned with simply signing the client and settling the claim. They want you to “call them” and they want to make a quick settlement with the insurance company. That’s it. It’s wrong. It’s bad for you.
The short-term focus of these lawyers (usually billboard or television lawyers) may lead to quicker settlements. But, these settlements are also usually lower. If you want the maximum compensation for your case, you need a lawyer who works hard (very hard) and is willing to go to trial. The short-term focus of these billboard lawyers also ignores medical reimbursement and subrogation issues. What good is a settlement if you simply have to give all the money to Blue Cross or Medicare? A good lawyer works hard to reduce these reimbursement claims whenever possible.
How can these recovery rights be complex? Each coverage provider has DIFFERENT rights. Medicare’s rights to recovery are different than Medicaid or Blue Cross. With Medicare, the government has far reaching rights to pursue claims against the injured party, as well as, their legal counsel and the original defendant.
Good lawyering in personal injury cases requires an attorney to understand the complex web of subrogation law. A skilled and dedicated lawyer understands how to deal effectively with specific providers. Do you want to give Medicare, Medicaid or Blue Cross too much of your settlement money? No, of course not. On the other hand, do you want Medicare, Medicaid or Blue Cross to sue you? No, of course not. Seek skilled counsel who studies the law and works solely for your interest.
