How the Inflation Reduction Act Does or Doesn't Affect Your Injury Settlement.pdf
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There's been lots of hoopla about the benefits of the Inflation Reduction Act for Medicare and Affordable Care Act enrollees. This presentation addresses how the new law really affects medical expenses which figure into your injury case evaluation.
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How the Inflation Reduction Act Does or Doesn't Affect Your Injury Settlement.pdf
- 1. HOW THE INFLATION REDUCTION ACT DOES OR DOESN’T AFFECT YOUR INJURY SETTLEMENT NSSTA FALL EDUCATION MEETING November 3, 2022 ©SnyderMediations.com
- 2. Theda (Teddy) Snyder, Esq., CSSC, mediates civil and administrative cases throughout California. Rated “preeminent” by Martindale Hubbell (highest rating), she has been an attorney for more than 40 years and has settled hundreds of cases and tried more than 100. An active author for the law practice management industry, her most recent book is The Lawyer’s Marketing Journal, published by AttorneyAtWork.com. She can be reached at TSnyder@SnyderMediations.com © SnyderMediations.com
- 3. CASE EVALUATION AND SETTLEMENT OF INJURY CASES REVIEW CLAIM-RELATED MEDICAL RECORDS AND MEDICAL PAYMENT HISTORY • DROP OUT UNIQUE PROCEDURES, e.g., SURGERIES • PROJECT FUTURE ONGOING CARE AND MEDICATIONS INCLUDING COLA IN ILLUSTRATION OF PRESENT VALUE • ADD IN FUTURE UNIQUE PROCEDURES AS LUMP SUMS ©SnyderMediations.com
- 4. WHO PAID PAST EXPENSES? WHO WILL PAY FUTURE EXPENSES? CIVIL LITIGATION PRIVATE INSURANCE MEDICARE MEDICAID OUT-OF-POCKET LIEN WORKERS COMP EMPLOYER CARRIER SELF-INSURED UNAUTHORIZED PRIVATE INSURANCE MEDICARE MEDICAID LIEN ©SnyderMediations.com
- 5. CIVIL LITIGATION COLLATERAL SOURCE RULE (most cases) WORKERS COMP PRIMARY PAYER RESPONSIBILITY (Medicare) ©SnyderMediations.com
- 6. CASE EVALUATION AND SETTLEMENT OF INJURY CASES INSURANCE PREMIUMS WHICH WOULD NOT BE NECESSARY BUT FOR THIS INJURY NON-MEDICARE ELIGIBLE EXPENSES ©SnyderMediations.com
- 7. INFLATION REDUCTION ACT OF 2022 H.R.5376 - Inflation Reduction Act of 2022 Public Law No: 117-169 Signed August 16, 2022 ©SnyderMediations.com
- 8. MINIMUM CORPORATE TAX ON PROFIT– 15% sort of STOCK BUYBACK TAX – 1% of fair market value INCREASED FUNDING FOR INTERNAL REVENUE SERVICE CLEAN ENERGY/ CARBON EMISSIONS REDUCTION AGRICULTURE/ FORESTRY PROVISIONS OTHER CLIMATE RESILIENCE PROVISIONS, INCUDING USE OF DEFENSE PRODUCTION ACT ©SnyderMediations.com
- 9. MEDICARE PRESCRIPTION DRUG FUNDING REFORM PRICE NEGOTIATION MAXIMUM OUT-OF-POCKET CAP PART D PREMIUM INCREASE LIMIT AFFORDABLE CARE ACT PREMIUM INCREASE LIMIT ©SnyderMediations.com
- 11. PART D ENACTED 2003 42 U.S.C. 1395w-111 Prescription Drug Plans (i) Noninterference.—In order to promote competition under this part and in carrying out this part, the Secretary [of Health and Human Services]— (1) may not interfere with the negotiations between drug manufacturers and pharmacies and PDP sponsors; and (2) may not require a particular formulary or institute a price structure for the reimbursement of covered part D drugs. ©SnyderMediations.com
- 14. THEN MEDICARE CAN NEGOTIATE THE PRICE OF DRUGS– RIGHT? NOT EXACTLY ©SnyderMediations.com
- 15. CHOOSE FROM THE 100 MOST EXPENSIVE DRUGS 50 FROM PART B/ 50 FROM PART D 10 in 2026 15 in 2027 30 in 2028 40 in 2029 and later years ©SnyderMediations.com
- 16. EXCEPTIONS PHARMACEUTICALS THAT HAVE BEEN MARKETED FOR 9 YEARS BIOTECH PHARMACEUTICALS (IN CONTRAST TO CHEMICAL COMPOUNDS) MARKETED FOR 13 YEARS “ORPHAN” DRUGS – EXCLUSIVE FDA APPROVAL TO TREAT CERTAIN RARE CONDITIONS (7 YEARS) ©SnyderMediations.com
- 18. $2,000 CAP ON OUT-OF-POCKET PRESCRIPTION EXPENSES including Donut Hole • Applies to drugs obtained through Plan D PDP or C • Cap starts in 2025 • In 2024, no 5% co-pay in catastrophic tier ©SnyderMediations.com
- 19. CIVIL LITIGATION COLLATERAL SOURCE RULE EVALUATION SPECULATIVE NEGOTIATION FLEXIBIITY ©SnyderMediations.com
- 20. SnyderMediations.com WORKERS COMP ONE POSSIBILITY: MSA MONEY SLUSHES UP NEGOTIATION FLEXIBILITY
- 21. PART D PREMIUMS MAY BE PART OF EVALUATION – PARTICULARLY FOR DISABLED RATHER THAN AGED IRA LIMITS INCREASES TO 6%/YR 2023-2030 ©SnyderMediations.com
- 22. ©SnyderMediations.com HEALTH INSURANCE INDUSTRY RESPONSE
- 23. AFFORDABLE CARE ACT PREMIUMS SUBSIDIES RESTORED THROUGH 2025 THEN WHAT? © SnyderMediations.com
- 25. ©SnyderMediations.com This Photo by Unknown Author is licensed under CC BY