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<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Alexis--I haven't dealt with this in a while but had to do quite a bit of research a few years ago, and I think I recall that the state's statutory bar on recovery
is <u>not</u> effective against <u>Medicare</u> Secondary Payer. The feds make their own rules. If I am remembering this right, it's different with
<u>Medicaid</u>, because that's federal funds paid to the State and then doled out under a State program, administered by DSHS, a state agency subject to the state's statutes.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">And, the recovery can be not just against the Estate, but anyone who received a portion of the proceeds. Some undigested chunks of info that I have from back
then:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">The authority of Medicare/Medicaid to come after everybody who has ever been associated with the settlement payout is statutory. The provision allows the feds
to look to the insurance company for proceeds even after the underlying tort case has been settled, policy has been exhausted or the like. The Centers for Medicare & Medicaid Services (“CMS”) may bring suit in the federal government’s name against any or
all of; 1) any or all plaintiffs, 2) any or all defendants, 3) any or all insurance carriers potentially subject to making any payment of any money to any claimant, 4) any person or entity which received any portion of settlement proceeds. See 42 U.S.C. §
1395y(b)(2)(A)(ii); 42 C.F.R. § 411.24(e). When read together, the statute and the CFR have been interpreted to include, inter alia, physicians and attorneys as persons receiving proceeds of payments and from whom a recovery may be sought. See 42 C.F.R. §
411.25(g). <o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">The only limitation to the assertion of a lien against an insurance company is that the lien is limited to the primary liability policies in effect. Thus,
any additional coverage held by the claimant, such as UM/UIM, umbrella or life insurance, is not subject to the lien. See Waters, et al. v Farmers Texas County Mutual Insurance Company, A.H.-92-942 (S.D. Tex. August 6, 1992).
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Sorry I don't have a useful cite for the exact issue -- whether or not Medicare recovery is subject to RCW 11.40.051.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#1F497D">Sincerely,<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#1F497D">Eric<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#1F497D">Eric C. Nelsen<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#1F497D">SAYRE LAW OFFICES, PLLC<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#1F497D">1320 University St<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#1F497D">Seattle WA 98101-2837<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#1F497D">phone 206-625-0092<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Calibri","sans-serif";color:#1F497D">fax 206-625-9040<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
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<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
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<p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> wsbapt-bounces@lists.wsbarppt.com [mailto:wsbapt-bounces@lists.wsbarppt.com]
<b>On Behalf Of </b>Alexis Singletary<br>
<b>Sent:</b> Thursday, May 19, 2016 7:29 AM<br>
<b>To:</b> WSBA Probate & Trust Listserv<br>
<b>Subject:</b> Re: [WSBAPT] Center for Medicare and Medicaid Services (CMD), Coordination of Benefits & Recovery (COB&R)<o:p></o:p></span></p>
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<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="color:#000099">Brief Estate Facts:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#000099"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="color:#000099">Man killed in motorcycle accident on 7/3/2013, age 59. No Will; not married, no kids, no parents, 4 siblings. On disability at time of death. Estate opened, 8/5/13; Notice to Creditors published beginning
8/16/2013; sent to DSHS/DOR on 8/15/13. Estate administered: $25,000 policy limits recovered each on 3<sup>rd</sup> party liability and 1<sup>st</sup> party UIM coverage; real estate transferred to one sibling via TEDRA; other siblings paid for share of estate
from sibling who retained house. Declaration of Completion filed 2/4/2016.<o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#000099"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="color:#000099">4/11/16 I receive a letter from Center for Medicare and Medicaid Services (CMD), Coordination of Benefits & Recovery (COB&R) notifying me that a Medicare Secondary Payer recovery case has been established in
their system. So, a subrogation claim for Medicare benefits paid on decedent’s behalf. I don’t see how any Medicare benefits could have been paid related to the Date of Incident since he was pronounced dead at the scene, but we’ll see what the Payment Summary/Demand
Letter we get in the next two months. Probably ambulance response, etc. but would be limited.
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#000099"><o:p> </o:p></span></p>
<p class="MsoNormal"><u><span style="color:#000099">My question for the group, and suspecting some of you have experience with COB&R, is</span></u><span style="color:#000099">:
<b>doesn’t the 2 year bar of RCW 11.40.051 apply?</b> I recall on the listserv a post that the bar applies to DSHS, but not sure on the overlap of what applies here for the Feds involved. Back in my old life I did some PI work and successfully got subrogation
claims waived where recovery was low policy limits such that the injured party was not made “whole”, so I think we can argue that, but best to say “too bad, you’re too late; by 8 months.”<o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#000099"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="color:#000099">Thoughts?<o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#000099">Thanks!<o:p></o:p></span></p>
<p class="MsoNormal"><span style="color:#000099">Alexis</span><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#000099"><o:p></o:p></span></p>
<p class="MsoNormal"><b><span style="font-size:11.0pt;color:#000099">____________________________<o:p></o:p></span></b></p>
<p class="MsoNormal"><b><span style="font-size:11.0pt;color:#000099">Alexis R. Singletary<o:p></o:p></span></b></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#000099">Attorney at Law<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;color:#000099">Singletary Law Office, PLLC<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;color:#000099">253.833.8855<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;color:#000099"><a href="http://www.singletarylawoffice.com/"><span style="color:#000099">www.SingletaryLawOffice.com</span></a><o:p></o:p></span></p>
<p class="MsoNormal"><i><span style="font-size:10.0pt;color:#000099"><o:p> </o:p></span></i></p>
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