Synergy’s blog brings you the industry’s foremost thought leadership InSights on matters of healthcare lien resolution and Medicare Secondary Payer Compliance. Visit often to discover helpful InSights on important lien resolution compliance issues.
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 reimbursement for the conditional payments it made on behalf of plan beneficiary under a Medicare Advantage […]
Repaying Medicare for conditional payments is a necessary but unpleasant process which can result in a greatly reduced net recovery or no recovery at all for an injured Medicare beneficiary. The Medicare Secondary Payer Statute has a repayment formula that is designed to maximize the return of funds to Medicare and provides no consideration for […]
Special Needs Trusts – The Differences By: Jason D. Lazarus, J.D., LL.M., MSCC, CSSC A special needs trust is a trust that can be created pursuant to Federal law whose corpus or any assets held in the trust do not count as resources for purposes of qualifying for Medicaid or SSI. Thus a personal injury […]
Are you Cutting A Check to the IRS this Year? By Daniel J. Alvarez, J.D. and Anthony F. Prieto, Jr., CFP® As the tax season draws to a close, you may be reviewing your tax return with some displeasure. Did you cut too large of a check to the Department of Treasury for your 2014 […]
By: Jason D. Lazarus, J.D., LL.M., MSCC, CSSC In a February 11, 2015 article from the Business Insider, Michael Kelly and Pamela Engel detail twenty one lottery winners who blew it all (see http://www.businessinsider.com/lottery-winners-who-lost-everything-2015-2?op=1). In the article, there are details regarding the myriad of ways fortunes were lost. For example, “Lara and Roger Griffiths bought […]
B. Josh Pettingill, MBA, MS, MSCC Vice President of MSP Compliance The “law” as it relates to Medicare Set Asides in liability settlements is an evolving area with new developments happening quite frequently. This year there have already been several noteworthy legal decisions pertaining to the protection of Medicare’s future interest in liability settlements. Below […]
Insurance carriers are bringing up the Medicare set aside (MSA) “issue” when it comes time to draft the release more frequently. In many instances, the plaintiffs are not yet eligible for Medicare benefits, nor may they ever be entitled to receive Medicare benefits. Plaintiff attorneys need to proceed with caution with regard to the Medicare […]
Applying Collateral Source Statutes to ERISA after Wurtz The U.S. Court of Appeals for the 2nd Circuit rendered a major decision on July 31, 2014 holding that New York’s anti-subrogation statute is “saved” from ERISA preemption. (Wurtz v. The Rawlings Company, — F.3d—, 2014 WL 3746801). This ruling holds that neither the express preemption found […]
Can a Third Party Hold Settlement Funds Until Medicare Issues a Final Demand? The Northern District of Indiana thinks it is a jury question as to whether or not the third party carrier acted reasonably in holding settlement funds until Medicare’s Final Demand had been issued (Dolgos v. Libery Mutual Ins. Co., 2013 U.S. Dist. […]