Workers’ Compensation Frequently Asked Questions (Part 1)

  • What statutory law, regulations, or Federal case law supports/allows CMS to review proposed settlements of injured workers who are not Medicare beneficiaries?
  • When dealing with a WC case, what is "a reasonable expectation" of Medicare enrollment within 30 months?
  • How does Medicare determine its interests in WC cases when the parties to the settlement do not explicitly state how much of the settlement is for past medical expenses and how much is for future medical expenses?
  • What's the difference between commutation and compromise cases? And can a single WC case possess both?
  • When a state WC judge approves a WC settlement, will Medicare accept the terms of that settlement?
  • What is the expected time frame for the regional offices (ROs) to review and make their decisions regarding proposed WC settlements?