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Medicare Conditional Payment Letters – Can a Lien be Too Low?

Imagine you have waited the 80 or so days it takes to get your first Medicare Conditional Payment Letter (the initial lien).  First, you take a quick glance and notice that the MSPRC has paid $5,000.  But then you realize that your client broke her hip and spent five months in convalescent care.

You think you hit the Jackpot?  Not quite – The MSPRC makes mistakes on Conditional Payment Letters.

The MSPRC probably will come back with a much larger lien when you request a Final Demand.  Even if it doesn’t, you, the attorney, may be liable for withholding information from the MSPRC.

Medical bills are a great asset when making settlement demands.  Their value extends to the healthcare lien process as well.  Take advantage of the bills – if they are significantly higher than the Medicare lien, you could send them to the MSPRC.  Doing so actually protects you and your client.  It also saves you the headache of a massive lien that you failed to account for in settlement.

The lien process is important.  If you do not take it seriously, you will be unable to distribute funds upon settlement.  Telling Medicare a lien is too low is just as important as spending the hours to audit a lien, and then compiling a Medicare lien dispute.  It may take time, but lien resolution is a necessary process.

Taking the time to notify the MSPRC of an incorrectly low Medicare lien can protect an attorney from government retribution.  This will become more important as the federal government continues to act aggressively in recouping Medicare funds.  The False Claims Act was recently amended to make it a violation to avoid an obligation to pay money to the federal government.  Essentially, it is now a violation of the False Claims Act if you fail to reimburse Medicare.  The penalty could include civil penalties of $5,000 to $10,000 per violation, treble damages, and attorney fees.

What is the best way to avoid these headaches?

Get Medicare lien help.  There are plenty of lien resolution providers out there.  A comprehensive audit of your Medicare liens and Conditional Payment Letters is the only way to know a lien amount is correct.

Ryan J. Weiner
Co-Founder Lien Resolution Services
This Blog/Web Site is made available by the publisher for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog site you understand that there is no attorney client relationship between you and the Blog/Web Site publisher. The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.

About Ryan J. Weiner

Co-Founder of Lien Resolution Services, LLC, a national healthcare lien resolution firm. Our goal is to assist in the fair administration and resolution of healthcare liens on personal injury cases. Please visit our website for more information: www.lienresolutionusa.com.

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