The Pro-Rata Method. How Medicaid Liens Actually Get Reduced.
A practical walk through the pro-rata formula that decides how much of a Medicaid lien you can cut.
Why does a state Medicaid agency so often demand the full amount it paid, even when the injury victim recovered only a
Beyond Ahlborn. How Wos Protects Injury Victims from Arbitrary State Recovery.
How the 2013 Supreme Court decision in Wos v. E.M.A. constrained the state statutory schemes that tried to work around Ahlborn, and what trial lawyers can do with the framework today.
Why does a 2013 Supreme Court case still control
Ahlborn Explained: How the Supreme Court’s Decision Limits State Medicaid Recovery to the Medical Portion of a Settlement.
How the federal anti-lien statute, the Supreme Court’s 2006 ruling, and the pro-rata formula shape what a state Medicaid agency can collect from a third-party settlement.
Why does a state Medicaid agency send a recovery letter demanding the full amount
Understanding Medicaid Liens: Federal Protections Every Personal Injury Professional Should Know
How the federal anti-lien statute, three Supreme Court rulings, and the pro-rata methodology shape state Medicaid recovery in personal injury cases.
You might ask yourself a simple question when a state Medicaid agency sends a recovery letter for the full
Beyond McCutchen: Practical Strategies for Reducing ERISA Liens
When the Supreme Court decided US Airways v. McCutchen in 2013, recovery vendors declared victory. The Court held that ERISA plan language governs reimbursement rights, and equitable defenses cannot override clear contractual terms.
Many attorneys took this to mean ERISA
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,
How 1024(b)(4) Requests Can Transform Your ERISA Lien Negotiations
If you’re negotiating ERISA liens without leveraging 1024(b)(4) requests, you’re leaving one of your most powerful tools on the table.
This federal statute creates a direct obligation for plan administrators to provide documents, and it comes with real penalties when
Self-Funded vs. Fully Insured: Why This Distinction Can Save Your Client Thousands
Every ERISA lien negotiation begins with the same critical question: Is this plan self-funded or fully insured?
Get this right, and you know exactly what legal framework applies. Get it wrong, and you could be leaving tens of thousands of
What Every Trial Lawyer Needs to Know About ERISA Liens
If your personal injury client has employer-sponsored health insurance, you’re almost certainly dealing with ERISA. And if you’re not prepared for what that means, you could be leaving significant money on the table or, worse, exposing your firm to liability.
Medicaid Lien Resolution Fundamentals: What Every Trial Lawyer Needs to Know
If your client is on Medicaid and settles a personal injury case, you will almost always face a Medicaid lien. How you handle that lien directly affects your client’s net recovery, your professional liability, and your firm’s reputation. Yet many
