As we have addressed previously, under the SMART Act, the Centers for Medicare & Medicaid Services (CMS) is required to set minimum Section 111 mandatory reporting thresholds for liability, no-fault, and workers' compensation claims. The reporting threshold also establishes a "safe harbor" regarding the repayment of Medicare conditional payments. The numbers may fluctuate from year to year. For example, in liability settlements, the recovery threshold was originally set as $300, then raised to $1000, then lowered to $750.
According to the announcement released December 15, 2021, CMS announced it would maintain the $750 recovery thresholds for 2022.
- Settlements of $750 or less for physical trauma-based liability settlements, no-fault insurance, and workers' compensation do not need to be reported
- Medicare's conditional payment amount related to these cases will not need to be repaid.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
