Q&A Medicare Protections:
Q: We are trying to do a $150,000 full C&R to a 50 year old employee who is now retired. We confirmed that he is currently NOT a Medicare Beneficiary. We checked with CMS and they do not have him in their system for any conditional payments. We have his statement that he has not applied for Social Security.
Is there anything else we should do to protect our client should CMS come after us in the future? I’ve heard of cases where the Employer got stuck even if they did all of the above.
A: Yes, submit the settlement with a “zero allocation addendum” to CMS with the below details, specifically requesting it approve a “zero allocation.”
This answer is “thinking outside the box:” it will not guarantee any protection from federal statutory law, but it certainly is evidence an employer “considered Medicare’s interests” in the settlement, which is the policy behind the applicable law(s).