What is a Medicare holdback?

Interesting information. Thanks Igloo.
Carol

You need to contact whomever was the personal injury or product liability lawyer who did your mom's claim/lawsuit. What you are dealing with is called The Medicare Secondary Payer Act (MSP), which is about Medicare being reimbursed for any payments they made for medical expenses for a Medicare covered individual in which another individual, business or other entity was later found responsible for and made a financial settlement to the Medicare covered individual. I think the regs on this finally came out this year. It's going to be a nightmare for self-insured's to comply with.

For your mom, what the medical charges total, what Medicare paid for and what the settlement paid to her is critical to determine how much everyone gets, this is why you need to see the attorney. It may be that the attorney will need to set up a trust account (kinda like how earnest $ is held when you buy a house) that the $ in the settlement goes to; and from that due to Medicare comes from and is not released to your mom until Medicare sends her attorney a letter that the reimbursement is settled in full and then the balance released to her. Enforcement of MSP is just gearing up as I think the reg's came down this year. IMHO we're going to have alot more of these happening just as the # of NH resident homes subject to MERP will be increasing as the fed's crackdown on compliance of Medicare & Medicaid reinbursement rules. Good luck. Let us know what the attorney says too - thanks.

Great answer. Thanks for the info. CYC