Ryan J. Weiner
SCOTUS Limits Medicaid Lien Recoveries
On March 20, 2013 the Supreme Court released its decision in Wos v. EMA, a federal case determining the legality of North Carolina’s Medicaid recovery statute. The Court held that the anti-lien provision of the federal Medicaid Act prevents a state from taking any portion of a judgment or settlement not designated as medical care. […]
SCOTUS: US Airways v. McCutchen Overruled
On April 16, 2013 the Supreme Court of the United States released its holding in US Airways v. McCutchen overruling the 3rd Circuit’s decision. The 3rd Circuit’s decision was part of a recent line of ERISA lien / ERISA reimbursement / ERISA subrogation cases with results in both directions. The following four cases are listed […]
SCOTUS: North Carolina Medicaid Recovery Limited by Federal Anti-Lien Statute
The Supreme Court has decided North Carolina’s Medicaid recoveries are limited by the federal anti-lien statute. The Court held the federal anti-lien provision pre-empts North Carolina’s irrebuttable statutory presumption that one-third of a tort recovery is attributable to medical expenses. This ruling has similarities to that of Arkansas v. Ahlborn. We will update this post […]
SMART Act: Final/Conditional Medicare Lien Process
Looking back at yesterday’s SMART Act post it is hard to decipher how to properly obtain what we are calling a “Final Conditional” Amount or Lien. We hope the following workflow (including our assumptions and expectations of the future process) will help: T-120 days to settlement – Send an Expected Settlement Notice to the MSPRC; […]
SMART Act: Is Medicare Lien Resolution Smarter Now?
On January 10, 2013, President Obama signed H.R. 1845. Included on the Medicare IVIG Access Bill is the SMART Act. SMART was designed to reform the conditional payment, final demand, and MMSEA Section 111 reporting processes. Click here to read the full text of H.R. 1845. As you can see below, we aren’t as excited […]
House & Senate Pass Medicare’s SMART Act
Both the House and Senate passed the SMART act prior to the Christmas holiday last week. In the House just 3 “no” votes were cast against 401 “yes” votes. The Senate passed the act without a single “no” vote. There is little doubt that President Obama will sign the bill into law. What is the […]
US Senate Passes SMART Act
The US Senate passed the SMART Act tonight, promising major changes to the Medicare lien resolution system. More to come.
NJ Court: Federal Law Does NOT Mandate Medicare Set-Asides
The United States District Court of New Jersey recently stated (albeit in an Unpublished Opinion) that Federal Law does not mandate Medicare Set-Asides in a liability context. The question arose in Sipler v. Trans. Am. Trucking Inc. following a general settlement for $225,000. After the verbal settlement the defense attorney attempted to insert language stating: […]
AAJ Working Toward 2nd Circuit Allocation of Medicare Lien
The AAJ sent out an update regarding a case where it is attempting to win a major victory for Medicare beneficiaries. The plaintiffs are using Bradley v. Sebelius to try to convince a probate court to allocate the settlement funds and reduce Medicare’s lien. The AAJ writes, In Bradley, the probate court ordered an apportionment […]
ERISA: Amicus Briefs Filed in US Airways v. McCutchen
During the U.S. Supreme Court’s upcoming term, the court is scheduled to hear U.S. Airways v. McCutchen, 663 F.3d 671 (3d Cir. 2011). We have previously written about the issue of equitable doctrines in ERISA: ERISA! ERISA! ERISA! A Primer; Ninth Circuit Reduces ERISA Lien Rights (CGI v. Rose); ERISA Liens: What You Need to […]
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