What Formal Opinion 2015-190 means for Medicare Secondary Payer compliance, conflict of interest exposure, and where your team should focus its time
In April 2026, the Oregon State Bar Board of Governors approved a revised version of Formal Opinion 2015-190. The opinion takes a clear position on a settlement practice you have seen plenty of times. A defense lawyer asks you to …
Medicare Conditional Payment Resolution: Best Practices for Personal Injury Legal Professionals
Medicare conditional payment resolution is one of the most important compliance steps in a personal injury settlement. When Medicare has paid injury-related medical expenses, those payments are made conditionally and may be subject to recovery after a settlement, judgment, award,
The Section 111 Penalty Era Has Started. It Is a Plaintiff Problem, Not an Insurer Problem.
Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 requires liability insurers, no-fault insurers, workers’ compensation carriers, and self-insured entities to report settlements, judgments, and awards involving Medicare beneficiaries to CMS. The reporting captures the beneficiary’s identity, …
CMS Is Testing AI on Medicare Claims. Here Is Why That Should Concern Every Personal Injury Firm Who Settles Cases for Medicare Beneficiaries.
For over two decades, the Medicare Secondary Payer Act has been the source of more confusion, frustration, and regulatory concern than just about any other issue personal injury firms face at settlement. As an industry commentator and someone with a …
Medicare Final Demand Isn’t the End of the Line
When a Medicare Final Demand arrives in the mail or your inbox, the clock starts ticking. Under the Medicare Secondary Payer recovery process, payment must be made within 60 days of the Final Demand letter to avoid interest on the
How to Build Medicare Compliance in a PI Firm
Medicare compliance sits at the center of modern personal injury practice operations. Trial lawyers and paralegals face real exposure when Medicare interests go unaddressed or get handled incorrectly. The risk is not abstract. Medicare can assert direct recovery rights, including
Medicare Compliance: Best Practices for Personal Injury Firms
Medicare compliance is not optional. It is an obligation that directly impacts your clients and your firm. The Medicare Secondary Payer Act (MSPA) makes Medicare the payer of last resort. That means Medicare must be reimbursed for any payments it
Part C: The Hidden Lien That Comes Back Later
You settled the case. Medicare was paid back. The file is closed. Or so you thought.
If your client had a Medicare Advantage Plan, also known as Part C, that “closed” file could come back to haunt you. Part C
How to Avoid Medicare Conditional Payment Mistakes That Delay Settlement
Medicare conditional payments are one of the most common sources of settlement delays, mistakes, and malpractice risk in personal injury litigation. They aren’t optional. They aren’t minor. And the Department of Justice has made it clear: if your firm fails
Post Final Demand Medicare Compromise & Waiver: Better Client Outcomes
When a Medicare final demand hits, the timer starts. Payment is due within 60 days or interest begins to accrue. If you miss that window, the debt can end up with the U.S. Treasury. But for personal injury firms, the
