Lien, Subrogation, or Reimbursement: The Distinction Every Trial Lawyer Must Understand
Three legal mechanisms attach to personal injury recoveries and confusing them costs your client money and exposes your firm to malpractice risk. Here is how trial lawyers and paralegals should classify, defend, and resolve each one.
When a personal injury
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
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 …
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
Reflections of a Medicare Secondary Payer Compliance Attorney Turned Recent Medicare Beneficiary
A significant portion of my legal practice has focused on workers’ compensation insurance defense. Although this area is rich with Medicare Secondary Payer (MSP) compliance guidance from the Centers for Medicare & Medicaid Services (CMS), it has often been misunderstood
