Compromise Exercised Only by CMS

50.4 – Compromise Exercised Only by CMS (Rev. 12438; Issued: 01-04-24; Effective: 02-06-24; Implementation: 02-06-24) If a beneficiary, attorney, or beneficiary’s representative offers to pay Medicare less than the full amount of its claim, the MSP Contractor informs the inquiring party of their rights to request waiver, appeal, or compromise of the claim. It advises them that while MSP Contractors may assist them in securing a waiver or appeal, MSP Contractors are not permitted to compromise claims on behalf of the Government. Then, the MSP Contractor follows the instructions at § 70.3 of this Chapter, which provide that a resolution through the FCCA is available through CMS at any time after the MSP Contractor is aware that Medicare has made conditional payments in a liability situation. The FCCA grants Medicare the right to compromise its claims, or to suspend or terminate its recovery action. However, only CMS may take this action. Consequently, MSP Contractors may not, under any circumstances, enter into negotiations (either pre- or post-settlement) with beneficiaries, or their attorneys or representatives, to compromise Medicare’s claim. If beneficiaries, or their attorneys or representatives, wish to discuss arrangements by which Medicare’s claim might be reduced (outside of a formal request for Medicare to waive its claim), the MSP Contractor either: 1) instructs the party to either make its request for compromise in writing, in which case the MSP Contractor forwards the request to CMS, or 2) refers the party directly to the appropriate staff person at CMS to handle the negotiation. MSP Contractors may advise an attorney or beneficiary that Medicare’s conditional payment must be considered during settlement negotiations with any third party.