Dispute
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; […]
ERISA, ERISA, ERISA!
In lien resolution (or subrogation, or reimbursement) ERISA means nothing. Let’s get that out of the way. Health plans can scream “ERISA!” at the top of their lungs. It still means nothing. One of 0ur younger attorneys at Lien Resolution Services dealt with this very issue last week. I like the way this ERISA lien […]
Medicare Advantage Plan Liens & Reimbursement
Medicare Advantage Plans often claim liens and/or reimbursement rights on personal injury lawsuits. This post isn’t about Medicare Advantage (“MA”) plan reimbursement rights (or whether the Medicare Secondary Payer statute allows federal actions for MA plans). Instead, this post aims to assist in reduction of MA plan liens. Last week, we were offered a 25% […]
How Will You React to Haro v. Sebelius?
As we all know, Medicare’s MSPRC agent has caused a ruckus with its freeze on issuance of Final Demands. This means you cannot pay Medicare liens right now. We think Haro v. Sebelius, a U.S. District Court of Arizona case is the cause for the Medicare lien freeze. See our analysis below: Haro v. Sebelius […]
Benson v. Sebelius: Bad News for Plaintiffs?
This post has been delayed due to recent Medicare Alerts. We apologize for said delay; however, we believe the recent Medicare Alerts are a higher concern. We continue to monitor Medicare’s decision to halt issuance of Final Demands. For updates, please continue to visit this blog at lienblog.wordpress.com or follow our twitter feed @LienResolve. […]
Haro v. Sebelius – Medicare Collections
In early May, Judge David C. Bury of the United States District Court of Arizona wrote the opinion for a major Medicare collections case, Haro v. Sebelius. Like much of the MSP Compliance profession, we have reviewed that case over the past few postings. Today’s posting is a short recap. First, Judge Bury’s holding: “IT […]
Med Mal Reform & Lien Resolution
The AAJ and Daily Kos are reporting the Obama administration’s proposed budget includes $250 million in Justice Department grants to help state rewrite their medical malpractice laws along the lines of recommendations from the deficit commission. The grants are meant to help states pursue innovative reforms which improve health care quality, reduce medical costs, and […]
Bradley v. Sebelius: Medicare Not Entitled
On September 29, 2010, the 11th Circuit Federal Court ruled that Medicare is not entitled to the proceeds of a wrongful death settlement paid to the surviving children of a Medicare recipient. This news is a welcome addition to the personal injury world, where Tort reform has put caps on many death case recoveries. Could […]
MMSEA – RRE Reporting Begins Oct. 1, 2010
President George W. Bush signed the Medicare Medicaid & SCHIP Extension Act (“MMSEA”) more than three years ago. On October 1st, 2010, its reporting section finally goes into effect. How will reporting change the Healthcare Lien landscape? How will it change Personal Injury Law? The Defense Fears The MMSEA turns defendant-insurers into Responsible Reporting Entities […]
Medicare Lien Appeals – The Five Levels
If you either (a) failed in your attempts to dispute MSPRC Conditional Payment Summaries, or, (b) simply did not dispute the Medicare lien prior to settlement, you have a series of options to reduce the client’s Medicare lien. While it isn’t really negotiating, we nonetheless term it, Negotiating With Medicare. The negotiation options: Compromise with […]
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