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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 […]
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 […]
Medicare Advantage Plans Entitled to Medicare Liens
In late June, the 3rd Circuit held that Medicare Advantage Plans (“MAP” or “MAPs”) have the same rights to reimbursement as regular Medicare. The district court in In Re Avandia Marketing, 2011 U.S. Dist. LEXIS 63544, (E.D. Penn. 2012) originally held the plans do not have the same rights to reimbursement as regular Medicare. However, […]
Misconceptions: It’s Not a Valid “Lien” Unless They Put Me on Notice
The most troubling “liens” are the ones that come up unexpected. But why do liens come up without warning? For starters, we have to remind you that we all use the term lien loosely. Most of the time we are not dealing with liens at all. The usual encumbrance is either a subrogation right, a […]
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% […]
Medicare Conditional Payment Notices
Yesterday I saw more Conditional Payment Notices from Medicare in one day, than I had the entire month of April. Conditional Payment Notices (“CPNs”) are different than Conditional Payment Letters (“CPLs”), but they should not concern you if you know how to respond. This post will discuss what is a CPN, what do to with […]
MSPRC to Introduce Web Portal in Summer 2012
The MSPRC has announced it will release a web portal for conditional payments much like that used for Workers’ Compensation MSAs. From the MSPRC release: Coming Soon – The Medicare Secondary Payer Recovery Portal A new online Self-Service Tool to help manage your Medicare recovery case. The Centers for Medicare & Medicaid Services (CMS) is […]
ERISA Liens: Greed was Never a Good Idea
Over the past 3 months we have seen some interesting trends developing in the case law behind ERISA liens. This post will not go into detail on those cases – but it’s time we shared this information: Cigna Corp. v. Amara in the Supreme Court: Although the district court did not have authority under Section […]
MSPRC to Offer Pre-Settlement Final Demands
The MSPRC recently announced a new option which essentially creates pre-settlement Final Demands for Medicare Liens. From its website: New Option to Self-Calculate Your Conditional Payment Amount On February 21, 2012, the Centers for Medicare & Medicaid Services (CMS) will implement an option that allows certain Medicare beneficiaries to self-calculate Medicare’s final conditional payment amount […]
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