How Humana Enforces the MSP Statute After Settlement

The Centers for Medicare and Medicaid Services (CMS) have repeatedly explained that MA and Prescription Drug Plans (PDP) should enforce the MSP rules or face potential penalties. Therefore, it is becoming more important than ever for the industry to be aware of how these plans are finding out about and tracking settlements and how to best protect injured parties’ Medicare benefits both before and after settlement.

But how is Humana able to make accurate coverage determinations, enforce MSP Statute, or issue post-settlement subrogation letters when CMS does not forward most Medicare Set Aside (MSA) details to MA and PDP Plans?

In this webinar you’ll learn:

  • Common FAQs regarding Humana coverage, denials, and subrogation
  • Brian’s background and how his role impacts decision made at Humana
  • How Humana determines when to issue subrogation letters for services post-settlement
  • How Humana enforces MSP Statute​​​​​​​
  • How Humana collects the data they need and what specific data is obtained from CMS & other sources​​​​​​​


To learn more, check out our interview with Brian Bargender!

Read the Interview

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