Over the last several years, a growing number of federal courts have held that Medicare Advantage Plans may seek recovery from defendants/insurers under the Medicare Secondary Payer Act and collect double damages if their liens are not resolved.
Recently we have seen an increase in the number of Advantage Plans seeking recovery of claims. The nation’s largest Medicare Advantage plan insurer, United Healthcare, recently has substantially increased their recovery efforts through Optum, a United Health Group company that handles lien recovery for Medicare Advantage and Medicare Part D prescription drug plans as well as other health plans. Optum has informed us that, under a new process they have implemented, once they receive notice of a claim they will actively search their records to identify any Medicare Advantage plans, any Medicare Part D plans, and any other health plans in which the claimant has been enrolled since the date of injury for which Optum may assert a lien. If any expenses have been paid that Optum claims are subject to reimbursement, Optum will assert such claims against the parties.
If you have any questions about Medicare Advantage or Medicare Part D liens, please do not hesitate to let us know. We are currently handling the lien negotiation and resolution process for numerous defendants and insurers facing claims asserted by Medicare Advantage and Medicare Part D plans. If you have any questions about whether a claimant may be enrolled in a plan, we can assist with confirming that information. We always seek to aggressively reduce any liens to try to achieve the best result possible for our clients.