42 CFR 411.37 - Amount of Medicare recovery when a primary payment is made as a result of a judgment or settlement
Cite as | 42 CFR 411.37 |
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61 practice notes
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State v. Peters, No. 17855.
...government has chosen to enact a pro rata reduction policy for medicare reimbursements, but has not done the same for medicaid. See 42 C.F.R. § 411.37(a)(1) (2006) ("[m]edicare reduces its recovery to take account of the cost of procuring the judgment or settlement . . . if—[i] [p]rocuremen......
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U.S. v. Baxter Intern., Inc., No. 01-16782.
...is the result of a judgment or a litigation settlement, which as a practical matter will almost always take more than 120 days. See 42 C.F.R. § 411.37 (providing that Medicare will deduct from its recovery a pro rata share of attorney fees and other "procurement expenses" incurred to secure......
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In re Zyprexa Products Liability Litigation, No. 04-MD-1596 (JBW).
...are incurred because the claim is disputed; and (li)[t]hose costs are borne by the party against which [Medicare] seeks to recover." 42 C.F.R. § 411.37(a). If the. Medicare lien is less than the amount of the settlement, the. reduction for attorneys' fees and expenses is equal to the ratio ......
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Bobo v. Tenn. Valley Auth., Civil Action No. CV 12-S-1930-NE
...plaintiffs will be required to pay.160 The amount of the claim recoverable from plaintiffs may be subject to reduction as provided in 42 C.F.R. § 411.37 (2013).161 L. Plaintiffs' SettlementsBarbara Bobo submitted claims for compensation to seventeen asbestos bankruptcy trusts following her ......
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50 cases
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State v. Peters, No. 17855.
...government has chosen to enact a pro rata reduction policy for medicare reimbursements, but has not done the same for medicaid. See 42 C.F.R. § 411.37(a)(1) (2006) ("[m]edicare reduces its recovery to take account of the cost of procuring the judgment or settlement . . . if—[i] [p]rocuremen......
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U.S. v. Baxter Intern., Inc., No. 01-16782.
...is the result of a judgment or a litigation settlement, which as a practical matter will almost always take more than 120 days. See 42 C.F.R. § 411.37 (providing that Medicare will deduct from its recovery a pro rata share of attorney fees and other "procurement expenses" incurred to secure......
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In re Zyprexa Products Liability Litigation, No. 04-MD-1596 (JBW).
...are incurred because the claim is disputed; and (li)[t]hose costs are borne by the party against which [Medicare] seeks to recover." 42 C.F.R. § 411.37(a). If the. Medicare lien is less than the amount of the settlement, the. reduction for attorneys' fees and expenses is equal to the ratio ......
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Bobo v. Tenn. Valley Auth., Civil Action No. CV 12-S-1930-NE
...plaintiffs will be required to pay.160 The amount of the claim recoverable from plaintiffs may be subject to reduction as provided in 42 C.F.R. § 411.37 (2013).161 L. Plaintiffs' SettlementsBarbara Bobo submitted claims for compensation to seventeen asbestos bankruptcy trusts following her ......
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2 firm's commentaries
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CMS Issues: Stark Voluntary Self-Referral Disclosure Protocol
...Disclosure Protocol is not a replacement or substitute for the advisory opinion process, which remains available and is described by 42 CFR §§ 411.37 through 411.389. The required elements in the process for participating in SRDP are described in the proposed protocol. You should be aware t......
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Beware of “Conscious Ignorance” Exception to Mutual Mistake Challenge to a Contract
...the judgment or settlement amount, the recovery amount is the total judgment or settlement payment minus the total procurement costs.” 42 C.F.R. 411.37(d). If no procurement costs or attorney’s fees are reflected on the final settlement detail documentation provide to Medicare at the time o......
4 books & journal articles
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Vol. 7, No. 6, Pg. 20. Medicare Recovery in Liability Cases.
...its recovery rights. 42 C.F.R. 411.24(h). One of the most important regulations to the personal injury lawyer (and the client) is 42 C.F.R. 411.37, which defines the exact amount of Medicare's repayment interest. The amount of Medicare's recovery is the amount of payments reduced by a share......
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June 2006 - #2. PERMANENT TOTAL DISABILITY UNDER VERMONT WORKERS' COMPENSATION LAW.
...and 42 C.F.R. 411.24 and 411.37(c)--(d) (2006). Medicaid's subrogation rights are codified in 42 U.S.C. 1396a(k) (2000). 42 C.F.R. 411.37. Interested parties may contact the State of Vermont Health Access Program, Coordinator of Benefits Unit in Williston, Vermont, regarding Medicaid's subr......
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Vol. 22, No. 1, 17. Workers' Compensation and Liability Lawyers Beware: Section 111 of the MMSEA Imposes Significant New Penalties for Failing to Protect Medicare's Interests.
...payment. See 42 U.S.C. § 1395y (b)(2)(B)(ii); 42 C.F.R. § 411.24(c)(2). Medicare's claim may be reduced by procurement costs. See 42 C.F.R. § 411.37. In addition to establishing Medicare's reimbursement right, the MSP requires primary payers to place Medicare on "notice" regarding certain c......
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SC Lawyer, May 2010, #3. Medicare Muscles Up: Complying with Medicare Secondary Payer Mandatory Reporting.
...for making the settlement (including the settling defendant or its insurer). See 42 U.S.C. § 1395y(b)(2)(B); 42 C.F.R. §§ 411.24 and 411.37. The Section 111 reporting requirements enhance Medicare's ability to identify "secondary payer" circumstances and recover conditional payments by forc......