Dad died from mesothelioma. My mother received settlements from a lawsuit filed for wrongful death. Now Medicare is trying to collect from her the funds they paid in medical bills when my dad was sick until he died. Is she responsible for this debt to medicare? This was not an accidental death benefit. This was a wrongful death suit. She has spent most of the money she received paying bills and supporting herself for the past 14 yrs? He paid into the medicare system all the years he worked. Isn't he entitled to the funds they paid. She wants to fill out the questionnaire requesting settlement amounts, etc and return to Medicare . I've told her to sit tight until we get legal advice.
This is a really tough issue. There is a Federal Statute known as the Medicare Secondary Payor Statute which basically says if there was some other entity that should have paid the medical expenses (such as workers compensation, lawsuits, private insurance...) then before settling a case or claim you must get Medicare's pre-authorization. Its even crazier since this has been on the books for years but has only been enforced within the last ten years. You may want to start out by speaking to the attorney(s) who handled the mesothelioma cases and go from there. There is also useful information at www.cms.gov (center for medicare services) good luck!
EVERY case is different. The answers provided here are general and not related to the specifc facts of your case. I am not your attorney and if necessary you should seek legal counsel.
Social Security Lawyers
You or your mom need to your attorneys about this first. It depends on what amount of money went to various potential parts of the claim - consortium for mom, pain and suffering for dad.......benefits for children, medical costs other than medicare paid bills. So, some amount may be protected.
Alternatively, if the lawyers do nothing, then you or mom may want to seek advice from a legal negligence attorney. CMS reimbursement is not new -it has been an active part of personal injury claims for at least 10 to 15 years in Ohio. While coming after Social Security recipients is a newer approach, workers' comp and PI claims in Ohio (and other states) have been forced to account for Medicare and Medicaid reimbursement for years, and the lawyers handling this claim either knew or likely should have known about that, provided legal advice about therisks and options, and done their part to protect the settlement.
As for the forms for Medicare, I suspect an attorney will tell you to answer the questions, be honest and cooperate. The risk of being non-responsive is thta SSA could suspend any Medicare eligibility until they get their questions answered, possible look at recovering money from SS benefits, and even threatening a fraud investigation. I doubt they could show fraud based on the facts you present, but putting people through such a charge to verify what really happened (or to force co-operation) is not unheard of.
Sorry you (and your mom) have had such a rough time. I hope things work out better for you in the future.
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