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How Medicare can affect a wrongful death settlement

The surviving family members of wrongful death victims in Texas and the rest of the U.S. often find themselves up against the Medicare Secondary Payer law. Under this law, Medicare may recover payments made on behalf of a beneficiary in the case of medical malpractice. When patients die as a result of medical errors, some family members attempt to file the suit solely as wrongful death to prevent Medicare from reclaiming the expenses. However, this does not always prove successful.

According to HHS, in the 2000s, the Administrative Law Judge decided that Medicare had the right to reclaim $171,537.04 plus interest it made in conditional payments on behalf of a beneficiary. In the specific case in question, the beneficiary who received the conditional payments fell ill, but his doctor failed to diagnose him with prostate cancer in time to save his life. He subsequently died. The surviving spouse and next of kin filed an appeal, requesting a review for this decision in 2016.

The court deliberated over whether or not the family knowingly neglected to include the aspect of the case related to medical errors to avoid reimbursing Medicare. In the end, the court decided that the appellants needed to repay the money paid out to them on behalf of the deceased beneficiary.

According to the American Bar Association, this is not an uncommon occurrence, when someone dies due to someone else’s fault or negligence. In these instances, the Secretary of the Department of Health and Human Services may seek repayment for Medicare disbursements from the deceased’s estate. This may affect not only the inheritance the party leaves behind, but any settlement the family received as compensation for the wrongful death of their loved one.

The organization acknowledges that Medicare may target the entire settlement amount when seeking repayment. However, in the case of wrongful death suits, some jurisdictions may allow families to plan carefully to protect settlements from these claims.

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