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Medicare Reporting Rules Still Not Final, and Questions Continue

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  • Topic: Top
  • - Popular with: Legal
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The Centers for Medicare and Medicaid Services has yet to finalize long-awaited new rules about pena…

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Do not post libelous remarks. You are solely responsible for the postings you input. By posting here you agree to hold harmless and indemnify WorkCompCentral for any damages and actions your post may cause.
Gary Nelson Jul 23, 2020 a 9:07 am PDT

The elephant in the room is this: The state passes workers' compensation reform laws that allow the carrier to decline to pay for necessary medical treatment. By their rules, the care is not needed and the injured worker cannot obtain it through the state system. Then, the worker self-procures the denied treatment through Medicare, which proves it was medically necessary. Later, the injured worker receives a bill from Medicare threatening them, without due process I might add, to pay a judgment for the care which is declared a "conditional payment."

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