Inspector General 2013 Report Unveils Increased TPL Savings, Even More is Feasible

In the January 2013 study, "Medicaid Third-Party Liability Savings Increased, But Challenges Remain," the U.S. Department of Health and Human Services' (HHS) Office of Inspector General (OIG) claims there's been a step-up in third-party liability (TPL) payments to states in cases where Medicaid customers hold additional medical insurance. This same report adds that states need aid in acquiring a hefty quantity of money, that rightly belongs to them, but is left on the table.

Within the 10 years between 2001 and 2011, the OIG identified that TPL savings by states increased from a savings of around $34 billion to a savings of over $72 billion, that equates to a growth of 114 percent in recovered savings over that period of time. On the other hand, problems remain for states receiving complete TPL recovery, with an assessed $4.1 billion of TPL debts vulnerable of never getting recaptured by states. The following instructions are advanced by the OIG to the Centers for Medicare & Medicaid Services (CMS) to solve states' complications with TPL collections:

• Facilitate states in focusing in on lingering complications with identifying insurance coverage and recovering payments from insurance companies;
• Aid states through the Medicare and TRICARE one-year timely filing limit problems; and
• Put some teeth into the enforcement of insurance companies that refuse to comply with prevailing statutes.

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