What is the statute of limitations for Medicare to institute an action for repayment of conditional payments used to be a question with more than one answer. In the past the Centers for Medicare and Medicaid Services (“CMS”) had argued that the six (6) year limitation period contained in the Federal Debt Collection Act for […]
An Administrative Services Agreement between a Plan Administrator and a Claims Administrator may fall within the purview of a document request under ERISA 29 U.S.C. § 1024(b)(4), with non-compliance subject to the penalty assessment authorized under ERISA 29 U.S.C. § 1132(c). As Synergy has long advocated, one of the keys to properly defending against an asserted subrogation or reimbursement claim from an ERISA plan is making requests to the plan administrator.
This case involved a Virginia plaintiff who was injured when a shower chair collapsed. The plaintiff had a pre-existing hip injury which involved an implanted prosthetic. Plaintiff’s counsel engaged Synergy Lien Resolution Service to assist in the resolution of the ERISA plan’s reimbursement claim. Despite the unfavorable law in the 4th Circuit, which was recently bolstered by U.S. Airways v.McCutchen, within two (2) weeks Synergy was able to obtain a 70.2% reduction for a savings of $85,955.02.
Medicare Advantage plans, otherwise known as Medicare Part C, have proven to be a hot and confusing topic for plaintiff’s attorneys over the past few years. Recent rulings by the U.S. Supreme Court and 9th Circuit have done little to eliminate this confusion. Instead, the latest
case law has increased the complexity.
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In WOS v. EMA, the first case to reach the US Supreme Court after Ahlborn, the highest Court in the land again examined a state statute requiring up to one-third of any damages recovered by an injury victim to be paid to the state to reimburse it for payments made by Medicaid for injury related treatment.
Are the defendants/insurance carriers throwing everything but the kitchen sink into your release language in regards to protecting Medicare’s interests?
Learn more about the Medicare recovery process under the MSP.
On December the 19th the Strengthening Medicare Secondary Payer Rules Act was passed by the House. The Senate passed the Act on December the 21st. It is on its way to President Obama to sign. While it modifies the Medicare Secondary Payer Act, it only streamlines the MSP conditional payment process and has nothing to do with Medicare Set Asides.