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Hummel Consultation Services is an advanced legal
consultation practice specializing in the interpretation and
application of the Medicare Secondary Payer Program.
HCS was founded in 2002 by Attorney Christine Hummel
and Joseph Hummel to respond to the growing concern
of the insurance industry to the increasing pressures by
the federal government upon all manner of
settlements, and to provide an innovative and exciting
approach to customer service not previously exhibited
by existing Medicare vendors.
The Medicare Secondary Payer Program, established under
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 all parties with an interest in
the settlement are in complete compliance with all conditions of the Medicare Secondary Payer
Program,
To act as a mediator between the parties to the
settlement and the federal government,
To provide a superior level of customer service
to all interested parties, regardless of any
formal relationship between them and HCS.
It is the objective of the entire staff of HCS to provide
the most accurate compliance services possible, at the
lowest cost to our customers, with the highest quality of
customer service.
The Medicare Secondary Payer Program 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, negotiation to dispute or appeal
the lien, compromising the lien, and 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 and Medicare Part D 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 approval services. HCS
drafts concise and detailed proposals designed to be analyzed by
CMS in the shortest possible time. In the rare event that our
proposals are rejected, HCS utilizes the mediation skills of our
attorneys to conduct CMS negotiations to obtain 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. HCS
has been very successful with zero-dollar MSA proposals to CMS.
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 enjoys a special relationship with the prominent structured
settlement companies, and can thus obtain rated ages and structure
quotes with no action necessary by our customers. HCS works
closely with the brokers to derive highly favorable annuity
quotes, and to assist our customers with final settlement
transactions.
Custodial Agreements. The attorneys of HCS draft Custodial
Agreements without the need to retain outside legal counsel to
do so, saving time and expense. Each are drafted specifically for each individual referral and
take into consideration the unique aspects of the state jurisdiction of
the claim. Our Custodial Agreements are currently in use with all
of the major professional administration companies, with whom
HCS enjoys a strong and mutual relationship, allowing HCS to
offer easy professional administration setup to our customers.
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 will furthermore forward settlement documents to CMS at no charge to its customers.
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 will provide comprehensive guidance and assistance with all of your Section 111
reporting needs.
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