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Medicare Conditional Payments

April 1, 2011 By Paul Giannetti

Medicare Conditional Payments are payments made by Medicare where another party, known as a primary payer, may legally be responsible to make payment but does not.

The primary payer, in the context of a personal injury action or Workers’ Compensation case, is usually an insurance company who should have made payment but instead the bill was paid by Medicare.

Conditional payments made by Medicare should be reimbursed by the primary payer before a claim is settled. If conditional payments are not properly satisfied, Medicare can begin an action against all primary payers who should have made payment in the first place.

If you have a pending Workers’ Compensation or personal injury claim and some of the medical bills have been paid through Medicare it is important that you notify your attorney so that the proper steps can be taken to satisfy Medicare’s rights.

If you have questions regarding a personal injury or Workers’ Compensation matter, please feel free to contact our office.

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