Third-Party Liability
The consultants in UMass Medical School’s Commonwealth Medicine division — through the Center for Health Care Financing — are experts in reducing the fiscal burden of treating medically-complex patients in Medicaid programs. By identifying liable third-party resources to pay some or all of the costs, we can produce significant financial savings for Medicaid programs and ensure that states remain the payers of last resort. This has the lasting effect of reducing stress on individual state Medicaid programs.
To lower costs for state Medicaid programs, the experienced professionals in our Center for Health Care Financing are dedicated to recovering Medicaid funds from third-parties such as these:
- Probated estates
- Worker’s compensation insurers
- Automobile liability insurers
- Medical malpractice insurance
- General liability
- Commercial insurers
- Medicare
Our proprietary analytical processes help states identify individuals who may be eligible for benefit programs supplemental to Medicaid. We also assist states in obtaining third-party insurance and resources for medically complex cases. When necessary, we file appeals to secure such coverage.
In addition, the Center for Health Care Financing consultants are experienced in recovering Medicaid dollars from liable parties for injuries due to accidents and trauma. And we work with courts and other agencies to identify and recover state funds from probated estates.
In Massachusetts, we work in conjunction with MassHealth, the state Medicaid program, to help some of the program’s most medically-complex, high-cost members to obtain, maintain, and coordinate their commercial health insurance benefits. This ensures that MassHealth is the payer of last resort.