Advanced Lien Resolution: Medicare, Medicaid, ERISA, and Military Liens
Introduction
Effective lien resolution is pivotal in personal injury cases. Liens—claims from healthcare providers, insurers, or government agencies against a plaintiff’s settlement—can significantly impact the net recovery. Understanding and managing these liens is crucial for maximizing the client’s recovery and …
Medicaid Lien Resolution Fundamentals
Medicaid liens often arise in personal injury cases where the injured party is indigent, and the program has covered the client’s medical expenses. Under federal law, Medicaid programs must recover these expenses from third-party settlements. However, the process is governed …
Do Hospitals and Providers Have to Bill Insurance, Including Medicare and Medicaid?
Introduction
The landscape of healthcare billing can be complex and confusing, both for healthcare providers and patients alike. When there is third-party liability involved, such as in cases of accidents or injuries caused by someone other than …
Synergy’s Workers’ Compensation Medicare Secondary Payer Advice Column
June 6, 2023
Rasa Fumagalli JD, MSCC, CMSP-F
The Medicare Secondary Payer Act impacts workers’ compensation, liability, and no-fault settlements involving a Medicare beneficiary. This month’s “Since You Asked” column addresses a situation where Medicare incorrectly denies non-injury-related treatment after …
What Gives Hospitals and Government Health Benefit Plans the Right to Recover
March 9, 2023
Introduction
Navigating the complex world of healthcare liens can be overwhelming, especially for cases involving military personnel, Veterans, Medicaid recipients and the uninsured who need hospital care. However, understanding the intricacies of programs like …
What Gives Health Care Plans The Right To Recover?
January 12, 2023
Dealing with medical liens is the dreaded case after the case for most personal injury attorneys. As a personal injury attorney, you’ve worked hard to prove the tortfeasor has liability for the damages incurred …
Advanced Strategies for Closing Cases Compliantly: A Case Study
November 11, 2021
In the confusing landscape of public benefits and planning issues that arise today for trial lawyers when settling catastrophic injury cases, finding your way can be a daunting task. Many
questions come up such as should the …
Primary Payer Status Shifts from Liability Carrier to Plaintiff Post-Settlement
Rasa Fumagalli JD, MSCC, CMSP-F
In Penelope Stillwell v State Farm Fire and Casualty Co., et al. case (2021 WL 4427081), a plaintiff attempts to impose primary payer status on a liability insurer post-settlement via a qui tam action …
What Should You Do About Possible Health Insurance Liens?
August 12, 2021
When handling a third-party liability case and you know your client had health insurance that paid the medical expenses, should you check to see if there is a lien interest on the settlement funds? …
Workers’ Compensation Medicare Set-Aside (WCMSA) Arrangement
April 8, 2021
Rasa Fumagalli JD, MSCC, CMSP-F
The nature of the Workers’ Compensation Medicare Set-Aside (WCMSA) has evolved over the years since the 2001 Patel Memo. That evolution has seen us move from every WCMSA that met the Center …
