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Recent Federal Medicare/Workers’ Comp Legislation

Congress has recently introduced legislation to improve the administration of Medicare in cases involving Workers’ Compensation settlements, and provide an avenue to appeal determinations by the Centers for Medicare and Medicaid Service (CMS).


The bipartisan bill introduced in both houses of Congress known as the Medicare Secondary Payer and Workers’ Compensation Settlement Agreements Act was proposed by Senators Bill Nelson (D-FL) and Rob Portman (R-OH), and Representatives Mike Thompson (D-CA) and Dave Reichert (R-WA).


The legislation establishes a consistent standard in the determination of settlements, resolving delays in the review of Workers’ Compensation Medicare set-asides for future medical and prescription costs, and provides an appeal process. It also requires CMS to abide by individual state Workers’ Compensation laws.


The legislation has received widespread support from claimant, employer and insurance groups.

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