2022 Medicare Safe Harbor & Reporting Threshold for Liability, No-Fault, and Workers’ Compensation Settlements Remains at $750
As we have addressed previously, under the SMART Act, the Centers for Medicare & Medicaid Services (CMS) is required to set minimum Section 111 mandatory reporting thresholds for liability, no-fault, and workers’ compensation claims. The reporting threshold also establishes a “safe harbor” regarding the repayment of Medicare conditional payments. The numbers may fluctuate from year to year. For example, in liability settlements, the recovery threshold was originally set as $300, then raised to $1000, then lowered to $750.
According to the announcement released December 15, 2021, CMS announced it would maintain the $750 recovery thresholds for 2022.
- Settlements of $750 or less for physical trauma-based liability settlements, no-fault insurance, and workers’ compensation do not need to be reported
- Medicare’s conditional payment amount related to these cases will not need to be repaid.
Practice Tip
The safe harbors give liability, no-fault, and workers’ compensation practitioners another option when compromising claims with otherwise potentially high Medicare conditional payment liens. Contact Teague Campbell’s Medicare Settlement Solutions team to explore these new options.
Have questions about Medicare conditional payments? Contact attorney Daniel Hayes with our Medicare Settlement Solutions team!
References:
https://www.cms.gov/files/document/computation-annual-recovery-thresholds-nghp-2022-1.pdf