Monthly Archives: July, 2013

Medicare Set Asides – Regulations Coming for Liability Settlements, CMS Issues Notice of Proposed Rulemaking

By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC

It appears Medicare is poised to begin the rulemaking process for Medicare Set Asides by issuing a notice for proposed rulemaking as early as September of this year.  As most of you know (from my previous blog posts), last year they issued an Advanced Notice of Proposed Rulemaking.  This was the first step in the regulatory process.  They solicited commentary from the legal community and industry stakeholders.  I was on AAJ’s committee that provided commentary.  I also drafted commentary of my own on behalf for Synergy.  I hope that CMS considers all of the commentary when crafting rules for set asides as if they don’t get this right, it could cause huge problems in the resolution of cases involving Medicare beneficiaries. 

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Synergy Happy Hour Tonight at AAJ

Synergy is the exclusive sponsor of the products liaiblity seciton of AAJ.  We will be hosting a happy hour at Novela tonight at 7 p.m.  Come joins us if your are in San Francisco!  Details are as follows:

7 p.m. @ Novela

662 Mission Street (between New Montgomery & Annie streets)

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Lien Res Success Story – Synergy reduces Medicare Conditional Payment demand by 95% increasing the plaintiff’s “take home” by 10 fold

Medicare, via MSPRC, asserted a lien for the conditional payments it had dvanced in the amount of $12,587.06.  Synergy was engaged to reduce the mount that the plaintiff must repay to Medicare and immediately began an ggressive lien resolution protocol.  The result of Synergy’s efforts was a Final Demand amount being issued by Medicare, via MSPRC, in the amount of $617.77.

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Lien Res Success Story – Synergy wipes out Medicare Condtional Payment Obligation

Medicare asserted a lien for conditional payments advanced in the amount of $1,595.00.  These charges were unrelated to the subject accident and were not claimed by the beneficiary in the personal injury case.  Synergy was able to successfully dispute these charges and Medicare agreed to reduce the balance owed to zero and to close their file. The result was a increase of 44% to the beneficiary’s net recovery. This case clearly demonstrates how on even the small dollar files Synergy can take steps that can make a significant impact on the plaintiff’s take home.

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Synergy Opens Miami Office – Sean Pendray Joins Synergy

Synergy is pleased and proud to announce that Sean S. Pendray has joined the Synergy team.  Sean brings substantial financial services and settlement consulting experience to Synergy.  Sean will be operating out of Synergy’s Miami office. All of his contact information is below.

Sean S. Pendray

Settlement Consultant

Synergy Settlement Services

10 Aragon Ave., #807

Miami, FL 33134

786.536.7017 (direct)

305.972.7480 (cell)

877.242.0022 (toll free)

786.513.0767 (fax)

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Lien Res Success Story – Synergy obtains Medicare refund of $31,185.63 for estate of deceased beneficiary

This case involved a Medicare beneficiary pedestrian who was struck and
severely injured by the tortfeasor’s automobile.  The attorney for the estate was able to obtain a policy limits settlement from the tortfeasor’s Bodily Injury carrier in the amount of $100,000.00.  Medicare had issued conditional payments in amount of $245,363.12 prior to the beneficiary’s death and asserted a Final Demand for the entire settlement, minus attorney fees and costs.  The estate paid the Final Demand and then engaged Synergy to attempt to obtain a waiver or compromise.  Synergy’s knowledge of both the MSPRC and CMS processes as well as experience in obtaining reductions from both resulted in a timely and favorable result.  The estate reduced its Medicare liability by 50% entitling it to a refund of $31,185.63.

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“Synergy is our guiding light for deferring our contingent legal fees and planning for retirement. The lawyers at Panter Panter & Sampedro, myself included, have been working with them for over ten years using different methods to defer comp and plan for retirement.”

Brett Panter
Panter, Panter & Sampedro

"I don't think I've directly said "thank you" for helping us with Bridgett’s case. We sent the reduced payment to Medicaid and called Bridgett's mom to tell her approximately how much money was going to be left for Bridgett and she broke down over the telephone. Given only $25k of insurance and a $850k medical bill from the hospital she didn't think Bridgett would ever see a penny."

Tom L. Copeland
Jeffrey Meldon & Associates, P.A.

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