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Hummel Consultation Services is an advanced legal
consultation practice specializing in the interpretation and
application of the Medicare Secondary Payer Act.
HCS was founded in 2002 by Attorney Christine Hummel
in response to the growing concern
of the liability, no-fault and workers' compensation insurance industries to the increasing pressures by
the federal government upon their
settlements, and to provide an innovative and exciting
approach to customer service not previously exhibited
by existing Medicare compliance vendors.
The Medicare Secondary Payer Act of December 5, 1980,
requires consideration of the interests of the Medicare
program within all settlements involving Medicare
beneficiaries. Federal regulations established by the
Centers for Medicare and Medicaid Services (CMS)
specifically outline the applicability of the Program to
the workers' compensation, liability and no-fault
claims.
The obligations of HCS to its clients are:
To ensure that our clients are in compliance with the Medicare Secondary Payer Act, and
To provide a superior level of customer service to our clients.
The Medicare Secondary Payer Act requires essentially
three major functions to be performed in a settlement
involving Medicare beneficiaries. The first is the
future medical allocation, sometimes referred to as a Medicare Set-Aside (MSA), the
second is conditional payment lien searches, and the third is the Section 111 reporting requirement.
Medicare Set-Asides. Through a detailed analysis of the medical records,
payment histories, life care plans, drug utilization reports,
and other related materials submitted by its customers, HCS
determines the MSA and its associated aspects, including, for
example, funding and administration options. HCS presents its
conclusions by way of an opinion letter. The opinion letter
designed by HCS is specifically tailored for the needs and
requirements of not only each client, but is also highly
specialized for the infinitely different needs of each
claimant. Every opinion letter will always include a legal
analysis and interpretation of the applicable Medicare
regulations upon the settlement and a breakdown of Medicare covered costs versus
non-Medicare covered costs. Each letter furthermore contains
a summarized yet comprehensive medical history of the claimant, not
just an outline of records reviewed. All of our calculations and
recommendations are clearly explained and completely supported by the
medical record; HCS never invents its own medical conclusions.
All HCS opinion letters also contain custom
drafted legal language for inclusion by the parties into their
settlement documents, saving our clients time and cost.
Settlement Advisory Letters. A complete MSA analysis is not necessarily appropriate
for every case scenario. In those instances where an MSA is either not required, or is not necessarily the best
future-medical solution, we offer a written assessment of the specific facts of the case, and our recommendations
for Medicare compliance in your settlement.
Set-Aside Critiques. HCS can review and comment on Set-Aside analyses prepared by
other parties to your case. Our assessments include highlighting errors in both the medical and legal conclusions, and
identifying issues that may impact you and your client's compliance with Medicare. This is a valuable tool for
protecting your client's interests.
Lien Searches. HCS will perform all aspects of the conditional payment
lien search, including obtaining the tentative
and final lien determinations, submit disputes and appeals of
the lien, submit alternative lien resolution options such as compromises or waivers, and provide instruction on how to satisfy any potential liens.
HCS works with both the BCRC and CRC for lien resolutions depending upon the type of claim.
HCS will also perform Medicare Part C (Advantage) and Medicare Part D (outpatient prescription medication) plan lien searches.
CMS Approval. Formal approval of an MSA is never required by CMS;
however, if the parties to the settlement desire approval
of the MSA, HCS provides complete submission services. HCS
drafts concise and detailed proposals designed to be analyzed by
CMS in the shortest possible time. HCS utilizes the mediation skills of our
attorneys to submit CMS re-reviews and amended reviews to negotiate figures that all
parties to the settlement will find acceptable.
Zero-Dollar MSAs. HCS is a leading proponent of the "zero-dollar MSA," a settlement
arrangement whereby no MSA is actually allocated. Our comprehensive
knowledge of the legal applications of the Medicare program allows
us a unique position in the Medicare compliance industry to strongly
advocate for our clients' requests for zero-dollar MSAs, a position
which non-legal based vendors have difficulty substantiating.
General Question Accounts. Many of our clients enjoy having their own personal legal
expert at their side when it comes to Medicare compliance issues. Through our unique program of the General Question Account,
we are available to you and your staff at any time to address your non-case specific Medicare questions. This program is useful when
you do not need to formally refer an entire case to us for analysis, but you have a Medicare issue that still requires assistance.
Brokerage Services. HCS can obtain rated ages and structure
quotes on behalf of our clients. HCS works
closely with structure brokers to derive annuity
quotes, and to assist our customers with final settlement
transactions.
Settlement Transactions. Not only does HCS draft
settlement language for inclusion into final settlement documents, but HCS will review
these documents in any form, drafts or finalized, for compliance with federal Medicare
law. HCS can provide post-settlement advice for the benefit of the parties involved in assisting
with final implementation of the Set-Aside arrangement.
Section 111 Reporting. At this time, HCS does not serve as a Section 111
reporting agent; however, we do provide comprehensive guidance and assistance with all of your Section 111
questions.
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