Medicare and Car Accident Claims

When it comes to car accidents and clients in Georgia with Medicare coverage, the analysis of who does what and when can be tricky. 

A hospital cannot bill Medicare if prompt (within 120 days) payment is expected from a liability insurer( car insurance for the at fault driver). 

Any billing to Medicare must happen with 12 months of the patient discharge from the hospital. If the patient has Medicare and the hospital does not bill Medicare within that 12 month window, then it can never come after the patient to pay the bill but it can still assert a Georgia Medical Lien against any potential injury settlement from the car accident. 

The hospital cannot have it both ways and submit to Medicare and make a lien claim. The submission to Medicare invalidates the lien claim.  See Medicare Secondary Payer Manual, Chapter 2 Sec 40.2 Provision E

If you don't have Medicare and are just fighting with the hospital on the amount of the lien, your sole attack is on the reasonableness of the cost of the medial care. OCGA 44-14-470 and 471. In a recent Georgia Supreme Court case, the Court allowed the Plaintiff to get discovery of how much the hospital got paid but certain health insurers and under other rate plans so that a jury could decide what is fair in the industry. Unfortunately for the actual victim, the Plaintiff's lawyer in this case should have taken the hospital's offer to settle for $8500 on a $21,000 bill. It's hard to beat that discount at trial. Bowden v. The Medical Center, Inc.

Client Reviews
My wife and I were hit by a tractor trailer in 2014. After extensive research online, we were deeply impressed with the various reviews we read on Google and Avvo and chose Chris to represent us. We could not have a made a better decision. Chris and his firm treated us like we were their only clients, soothed our worries, and instantly gained our trust. Chris settled both of our cases for more than we expected.
A co-worker of my wife recommended Chris to us. At the very beginning Chris showed that he cared and his knowledge is priceless. Going through this process can be aggravating but Chris did a great job guiding me through this and was always available to answer my questions. Chris fought to get what I deserved even though at times I wanted to give up. Tracy
I want to express my deepest sense of gratitude and appreciation to Attorney Chris Simon & Attorney Chris Carsten, for all the hard work that they put forth into my case (car accident filed after being hit by drunk driver). Their attention to detail and professionalism far surpasses their firm's reputation. Because of their diligence and dedication to their craft, they were able to bring my case to a successful close, one that I could live with. You will not find a better team for your case. Should I have a need for their services again in the future, or know of anyone looking for a top notch Auto Accident Law Firm, I would not hesitate to recommend them!!!! Elle
Wow...Chris is a very good attorney. Me and my son was in a very bad car accident an I was clueless on how to handle the situation. It's very hard to find an attorney who allows you to contact them personally instead of you contacting their asst. I was told that I didn't have a case because the hosiptal put a lien on my acct. Chris prove different and I was able to file my case with the insurance company. The process was very quickly and Im glad I selected the right attorney..Thanks Chris A Car Accident client
Chris is a great lawyer and the most people friendly attorney I have ever delt with. He handled my case with great attention to detail and did so in a very short period of time. He is very consice, efficient, patient and understanding. He has a strong passion for what he does and he does it well. I recommend Chris Simon as legal representation for anyone who has suffreed damages or a loss at the negligence of others. He really cares about you and your case. A Car Accident client