c. If the costs of recovery do not fully justify the effort.


6. It is advisable to consider the Medicare issue at the outset of representation. If the chances of recovery are going to be limited (i.e., fall down case), and the lien is high, it may not make sense to go forward, as the spectre of the Medicare lien will make a tough situation worse.


7. The appropriate time to contact Medicare is sev- eral months prior to the onset of serious settlement negotiations or trial. Medicare is slow to respond and claiming lack of notice is not an excuse.


8. In Maryland, contact can be made with: Highmark Camp Hill, Pennsylvania (800) 999-1118. Or, in the alternative, mail to: Medicare COB MSP Claim Investigation Payments P.O. Box 5041 New York, New York 10776-5041.


9. There are two, useful publications and all practi- tioners faced with Medicare lien issues are advised to read them. They are: • Overview of the Medicare Secondary Payor Act; and


• Medicare Secondary Payor Frequently Asked Questions and Answers for Attorneys.


They are available at www.maryland medicare.com.


10. Finally, the expansion of the Medicare program to include drug benefits will increase both the size of the liens and the time it takes for Medi- care to respond. It would be wise to contact the COB office early and to thoroughly review the claimed lien to determine that only benefits re- lated to the claim are included.


There are numerous other nuances of the system that go beyond the depth of this article. A great source of information would be the written materials provided by Richard Neuworth at the “Don’t Get Bit” seminar held by the MTLA on October 10, 2005.


Let Us Do Your Medical Homework! Fox-O’Connell Consulting


Legal Nurse Consultants www.fox-oconnell.com


Any case dealing with health, injury or illness. Case Screening - Case Summaries - Timelines - Chronologies Research-Standards of Care Issues


301-524-0806 Winter 2006 301-524-3005 Trial Reporter 23


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