Maryland Enacts Regulations Requiring Consideration of Medicare’s Interests

On September 13, 2011, we published a blog discussing the fact that Maryland was once again proposing regulations affecting workers’ compensation settlements. The regulations were specifically centered on ensuring that Medicare’s interests are protected before a settlement will be formally approved. On November 28, 2011, the regulations were enacted.

In summary, the Maryland regulations require that Medicare’s interests be protected and that CMS’ directives be complied with, but they do not mandate submission of MSAs meeting the CMS workload review thresholds which are purely voluntary. The regulations harmonize with current CMS policies and procedures, and are in line with CMS’ May 11, 2011 memorandum which provides that submission of MSAs which meet CMS review threshold is a recommended procedure (not mandatory). For a copy of the May 11, 2011 memorandum, please click here.

Additionally, the regulations also require a statement that the insurer shall reimburse Medicare for any conditional payments that are determined to be the responsibility of the employer/insurer in a non-compromise case. Those affected by the Maryland regulations should therefore ensure that they aware of and research any conditional payments that may be owed to Medicare prior to settlement. To view details of the final enacted regulations please click here.

Maryland is the first state to enact requirements for the consideration of Medicare’s interests in their workers’ compensation regulations. The regulations appear to be reasonable and provide for compliance with the MSP. Whether other states will follow suit remains to be seen. PMSI will continue to follow this issue.

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