Medicare Secondary Payer and Settlement Delay

22 Pages Posted: 7 May 2018

See all articles by Eric Helland

Eric Helland

Claremont McKenna College - Robert Day School of Economics and Finance; RAND

Jonathan Klick

University of Pennsylvania Law School; Erasmus School of Law; PERC - Property and Environment Research Center

Multiple version iconThere are 2 versions of this paper

Date Written: June 2018

Abstract

The Medicare Secondary Payer Act of 1980 and its subsequent amendments require that insurers and self‐insured companies report settlements, awards, and judgments that involve a Medicare beneficiary to the Centers for Medicare and Medicaid Services. The parties then may be required to compensate CMS for its conditional payments. In a simple settlement model, this makes settlement less likely. Also, the reporting delays and uncertainty regarding the size of these conditional payments are likely to further frustrate the settlement process. We provide results, using data from a large insurer, showing that, on average, implementation of the MSP reporting amendments led to a delay in the resolution of disputes involving auto accidents of about six months.

Suggested Citation

Helland, Eric A. and Klick, Jonathan, Medicare Secondary Payer and Settlement Delay (June 2018). Journal of Empirical Legal Studies, Vol. 15, Issue 2, pp. 356-377, 2018. Available at SSRN: https://ssrn.com/abstract=3173375 or http://dx.doi.org/10.1111/jels.12181

Eric A. Helland (Contact Author)

Claremont McKenna College - Robert Day School of Economics and Finance ( email )

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Jonathan Klick

University of Pennsylvania Law School ( email )

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Erasmus School of Law ( email )

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PERC - Property and Environment Research Center

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