How to Navigate Conditional Payment Resolution
Medicare conditional payments are a persistent challenge for personal injury firms resolving cases for Medicare beneficiaries they represent. If a client is a Medicare beneficiary, you’re automatically dealing with the Medicare Secondary Payer Act (MSPA). The stakes are high. A
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 …
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
Could a Law Firm Owe Double a Part C Plan Lien?
Law firms handling personal injury cases know they must protect Medicare’s interest when it comes to conditional payments. But fewer realize the steep risk involved when that Medicare claim comes from a Part C Medicare Advantage plan. Under federal law,
Understanding Medicare Conditional Payments: Timelines, Final Demands & Your Obligations
Medicare conditional payment resolution poses substantial risk for trial lawyers and paralegals when timelines slip or deadlines get missed. The Centers for Medicare and Medicaid Services (CMS) publishes formal response standards, but real-world experience may not match those expectations. Knowing
Understanding Medicare Compliance in Personal Injury Settlements
If your client is on Medicare, Medicare compliance must be part of your resolution strategy. Failing to address the Medicare Secondary Payer Act (MSP) can trigger denials of future care, government recovery actions, or worse, personal liability for your law
