Supreme Court Decides Nevils: FEHBA Subro – “Shall Supersede and Preempt any State or Local law”
On April 18, 2017 in Coventry Health Care Of Mo., Inc. V. Nevils the United States Supreme Court held that the subrogation/reimbursement plan language contained in the health insurance contracts of Federal Employee Health Benefit plans (FEHBA) preempted state law. …
Supreme Court Rejects Change in Lien Res. Outsourcing
After nearly five years, on October 6, 2016, the Florida Supreme Court issued Opinion SC16-104 and declined to make any change to the existing Rules Regulating the Florida Bar in relation to lien resolution outsourcing. As Florida’s trial attorneys know, …
Medicare Reduces Reporting Threshold from $1,000 to $750
Medicare has reduced the threshold for when a physical trauma-based liability settlement is large enough that the beneficiary needs to report it and repay conditional payments. On November 15, 2016, the Centers for Medicare & Medicaid Services (“CMS”) issued an …
Damages “shall” be in an amount double… Medicare Advantage Plans
On Monday, August 8th, the 11th Circuit affirmed the decision of the Southern District of Florida to award a Humana Medicare Advantage plan double damages when they were not repaid at the conclusion of a personal injury …
Is an Attorney Personally Liable to Repay Humana for Part C (Advantage plan) lien?
This case has gained national attention amongst the trial bar for its far reaching implications. Synergy is on the forefront of protecting plaintiffs and the plaintiff’s bar which is why we feel so strongly about how the court in this …
1024(b)(4) – Send It To The Right Place!
In Allena Burge Smiley v. Hartford Life and Accident Insurance Company, et. al, No. 15-10056 (11th Cir. 2015), the Eleventh Circuit reiterated what Synergy regularly advises clients to do regarding the statutory document request pursuant to 29 U.S.C. 1024(b)(4) …
Finally an ERISA Subrogation Victory for Plaintiffs
Montanile v. Board of Trustees of National Elevator, 577 U.S. ____ (2016)
In the post McCutchen world wherein trial attorneys find themselves at the mercy of ERISA Plans, it was with a measure of dread that we anticipated another unfavorable …
New Medicare Portal Goes Live January 2016
On November 9th 2015 The Centers for Medicare & Medicaid Services (CMS) announced the much anticipated, and long overdue, start date for the new Medicare Secondary Payer Recovery Portal (MSPRP). The new MSPRP will begin functioning on January 1, …
Double Damages For Medicare Advantage Plans? – 11th Circuit To Decide
In Humana Medical Plan, Inc. v. Western Heritage Insurance Co., No. 12-20123, 2015 U.S. Dist. LEXIS 31875, the U.S. District Court for the Southern District of Florida granted Humana’s Motion for Summary Judgment and held that Humana’s right to …
Humana vs. Western Heritage – Double Damages for Medicare Advantage Plans
In Humana Medical Plan, Inc. v. Western Heritage Insurance Co., No. 12-20123, 2015 U.S. Dist. LEXIS 31875, the U.S. District Court for the Southern District of Florida granted Humana’s Motion for Summary Judgment and held that Humana’s right to …
