Injured Workers: Did You Receive a Letter About Reimbursing Medicare?
Last Updated on August 28, 2023
Investigation Complete
Attorneys working with ClassAction.org have finished their investigation into this matter.
Check back for any potential updates and take a look at our open investigations here. The information on this page is for reference only.
At A Glance
- This Alert Affects:
- Anyone who was hurt at work and received a letter saying that Medicare needed to be paid back for medical services it covered for the injury.
- What’s Going On?
- It is believed that workers' compensation claimants are receiving distressing letters from Medicare demanding reimbursement for medical expenses. Attorneys are investigating whether insurance companies are failing to pay Medicare in a timely manner, and whether patients can take action for out-of-pocket expenses, co-pays and other damages.
- What You Can Do
- If you received one of these letters – often referred to as “conditional payment letters” – fill out the form on this page to learn more about this investigation and why you may be owed money back.
- What Does This Cost?
- Nothing – and you’re never obligated to take legal action just because you spoke to someone about your rights.
Attorneys working with ClassAction.org would like to speak to individuals who were hurt at work, received medical treatment for their injury, and later received a letter saying that Medicare needed to be paid back for the services it covered.
What’s Going On?
Allegations have surfaced that some workers’ compensation insurance carriers are denying responsibility for workers’ injuries and, when the injured party is covered by Medicare, shifting the cost to the government program.
When the carrier finally accepts that it should have been the one to pay for the treatment, it waits until the very last minute to reimburse Medicare.
In the meantime, injured workers are being forced to pay for co-payments and other out-of-pocket expenses under the Medicare system that they would not have owed under workers’ compensation.
Further, patients are being copied on letters sent to insurance companies regarding the repayment of claims; many are rightfully worried that they are the ones responsible for paying back Medicare – when the letters are actually intended for the insurance company and are simply a notice to the patient.
Attorneys working with ClassAction.org are investigating which insurance companies may be engaged in these practices and whether class action lawsuits can be brought on behalf of injured workers who were financially harmed as a result.
What Does This Letter Look Like?
The letters are usually addressed to a health insurance company and may be marked with “copy” or “for information only.” The notice may state that Medicare has identified a claim that it made payment on and that it must recover this money from the entity responsible. It may refer to this amount as an “outstanding conditional payment.”
How Can a Class Action Lawsuit Help?
A class action lawsuit could help workers recover co-pays and any other out-of-pocket expenses they had to pay in connection with their on-the-job injury. A successful case could also serve as a warning to insurance companies that fail to pay back Medicare in a timely manner.
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