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The federal government shutdown has blocked some portions of Medicare Secondary Payer compliance from being conducted, according to Roy Franco, principal of Medicare compliance firm Franco Signor L.L.C.
The Centers for Medicare and Medicaid Services requires insurers and self-insured employers to reimburse it for medical treatment it paid on behalf of workers compensation and liability claimants. CMS issues notifications and approvals for Medicare reimbursements that it is owed.
In a blog post Friday, Mr. Franco said that key personnel within CMS have been furloughed during the shutdown, prohibiting the approval of Medicare set-asides — accounts that Medicare requires payers to fund for a Medicare beneficiary's future medical care.
Mr. Franco, who is immediate past chairman of the Washington-based Medicare Advocacy Recovery Coalition, said private contractors that handle certain Medicare Secondary Payer compliance tasks are still operating during the shutdown.
The U.S. Supreme Court has been petitioned to review the case of a Texas man who sued under Medicare Secondary Payer law to recover double damages from his workers compensation insurer for two back surgeries.