If a medical provider or SNF is sued for improper Medicare or Medi-Cal billing, is an estate or a trust entitled to reimbursement for lien payments made?

I am reading an uptick in DOJ and other actions against medical and nursing home providers for improper and sometimes fraudulent Medicare or Medicaid/Medi-Cal billing practices. And, in some of those situations the estate of a decedent or their trust may have been required to pay on a Medicare or Medicaid/Medi-Cal lien for services provided before the decedent died. So, I’m just wondering, and I don’t know the answer, but it is an issue – shouldn’t the estate or trust that paid on the lien be entitled to reimbursement of some or all of the money that it paid, or at least reimbursement for the improper or fraudulent billing amounts? It certainly seems so. Now, in many of those situations it might not be economically worthwhile to hire legal counsel to pursue the reimbursement if the lien payments are not sufficiently large. But in all of those cases where Medicare or Medicaid/Medi-Cal recover against medical or nursing home providers for improper payments, shouldn’t Medicare or Medicaid/Medi-Cal also have to affirmatively reach out and voluntarily provide refunds to the estates and trusts that were also overcharged on the resulting recovery lien?

Words for thought. Best, Dave Tate, Esq., San Francisco and California

 

 

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