MEDICARE AND MEDICAID LIENS:SUBROGATION AND REIMBURSEMENT AN OVERVIEW
By Paul J. Gitnik, J.D., LL.M.
Abstract
The Medicare and Medicaid programs were created as amendments to Title XIX of the Social Security Act, which was originally signed into law by President Franklin D. Roosevelt in 1935. President Lyndon B. Johnson, on July 30, 1965, signed the Medicare and Medicaid programs into law during a signing ceremony in Independence, Missouri. Former President Harry S. Truman attended the ceremony and was the first member enrolled into the Medicare program. It was President Johnson who actually enrolled Truman and distributed to him the first ever Medicare card.
The Medicare part of the amendment was created, in large part, to provide hospital and health insurance for older individuals. The Medicaid aspect of the amendment was designed primarily to temporarily provide certain low-income individuals and families health care services.
The Centers for Medicare and Medicaid Services (CMS), a component of the Department of Health and Human Services (HHS), oversees Medicare; however, private insurance companies have been given the responsibility of administering the program. In other words, private insurance companies have the responsibility of receiving claims, processing payments, making payments, enrolling health professionals, etc. Medicaid, on the other hand, is partially funded at the federal level, but is also partially funded by individual states. Administration, however, is entirely at the state level, though guided by federal statute.
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