Many lawyers are still unaware of the upcoming enforcement of new Medicare reporting rules, let alone versed on how to prepare clients.

And some insurers, fearful of running afoul of the rules, are engaging in practices that have delayed getting awards to plaintiffs.

New Medicare Secondary Payer reporting rules require attorneys, insurers and even plaintiffs to report any personal injury settlement, judgment or other award to the Centers for Medicare and Medicaid Services (CMS) in cases where Medicare has rendered payment or could render future payments for care based on the injury alleged in the case. Failure to do so could result not only in CMS slapping a lien on the award for Medicare reimbursement, but also fines of up to $1,000 per day.

Due to the confusion over the rules, the government has postponed enforcement twice. Now, the reporting requirements are set to go into effect Jan. 1, 2011.

But the reporting rules apply to one-time payments made on or after Oct. 1, 2010 and ongoing-care settlements and awards made on or after Jan. 1, 2010, so lawyers who have yet to prepare for them are already behind the ball.

All of this has personal injury and elder law attorneys, insurers and clients on edge.

“The reason everyone is so scared is because as soon as you touch the money, you are on the hook,” said Christine Alsop, a partner at the Webster Groves, Mo. elder law firm Oelbaum, Brown & Alsop, where she works with plaintiffs’ and defense attorneys as well as insurers on Medicare reporting requirement issues and set-aside trust creation.

“Many times insurance companies — because of their fear about the rules — have said ‘we’re going to put Medicare’s name on the draft of the check,’” said Mark C. Joye of the Joye Law Firm, a personal injury firm in North Charleston, S.C.

Such a move creates problems that can delay the settlement process or stop it altogether, because negotiating such a payment is difficult if not impossible for the client or CMS. “That will scuttle the settlement,” Joye said.

Read full article here

http://wislawjournal.com/article.cfm/2010/07/26/Medicare-setaside-rules-continue-to-baffle-Many-lawyers-arent-aware-of-new-rules

With the enactment of SB 1018 (Simitian), which requires all bank employees to report all suspected cases of elder financial abuse going into effect today, the California Bankers Association has compiled a list of tips to help consumers be more vigilant in keeping seniors safe.

"More and more, California's seniors have become the targets of unscrupulous fraudsters who want nothing more than to part seniors from their hard-earned money," said CBA president and CEO Janet W. Lamkin. "While law enforcement, along with California's financial institutions, work hard to make sure that suspected cases of elder financial abuse are reported and investigated, we want to remind all Californians that we all have a role to play in keeping our seniors safe."

Elder financial abuse is a somewhat unique crime in that, oftentimes, it is a member of the family, close friend or caregiver who ends up perpetrating the crime, making it that much more difficult to detect.

CBA encourages all Californians to look out for these common elder financial abuse schemes:

- Misappropriation of income or assets - Fraudster obtains access to an elder's Social Security checks, pension payments, checking or savings account, credit card or ATM, or withholds portions of checks cashed for an elder.

- Charging excessive rent or fees for service - Perpetrator charges an elder an excessive rent or unreasonable fees for basic care services such as transportation, food, or medicine.

- Obtaining money or property by undue influence, misrepresentation, or fraud - Perpetrator coerces an elder into signing over investments, real estate or other assets through the use of manipulation, intimidation or threats.

- Pigeon drop - Perpetrator claims to have found a sum of money and offers to split it with an elder provided the elder first withdraws an amount equal to his or her share as a sign of good faith.

- Fake accident ploy - Perpetrator convinces an elder that the elder's child has been seriously injured or is in jail and needs money for medical treatment or bail.

- Telemarketing and mail fraud - Perpetrator persuades an elder to buy a valueless or nonexistent product, donate to a bogus charity or invest in a fictitious enterprise.

- Fake prizes - Perpetrator tells an elder that he or she has won a nonexistent prize and either asks the elder to send a check to pay the taxes on this nonexistent prize or obtains the elder's credit card or checking account number to pay for shipping and handling charges for the prize.

- Unsolicited work - Perpetrator arrives unexpectedly at an elder's residence and offers to perform work for a reasonable fee; after starting the work, the perpetrator insists that the elder pay more than originally agreed before the work will be completed.

CBA reminds all Californians that if they believe that a senior they know and care about is being targeted with one of these fraud schemes, they should contact their county's Adult Protective Services agency immediately and report it.

Information about CBA

Established more than 110 years ago, the California Bankers Association (CBA) is one of the largest state banking trade associations in the country. CBA leads the way in developing relevant educational and legislative solutions to some of California's more pressing financial and banking issues, including adult financial empowerment, identity theft, financial privacy, and financial elder abuse. CBA's membership includes more than 300 of California's commercial, industrial and community banks and savings associations.