Recently, the United States Department of Health and Human Services (“HHS”) released a new report to Congress to explain data that the Centers for Medicare and Medicaid Services (“CMS”) used to calculate and uses to substantiate its threshold figures. Under the Strengthening Medicare and Repaying Taxpayers Act of 2012 (“SMART” Act), the HHS Secretary is required to calculate and publish an annual single “low dollar” threshold below which reporting and conditional payments are not required for trauma-based liability and workers’ compensation claims.
Beginning January 1, 2017, the threshold for physical trauma-based liability settlements will reduce to $750.00. CMS will maintain the current $750.00 threshold for workers’ compensation and no-fault settlements in cases where the workers’ compensation or no-fault payer does not otherwise have a responsibility for medicals. According to CMS, this means that entities are not required to report, and CMS will not seek recovery on these types of settlements falling under these thresholds.