Monthly Archives: October, 2014

New Ammunition to Eliminate or Reduce FEHBA Subrogation/Reimbursement Repayments

The Federal Employees Health Benefits Act (FEHBA) of 1959 (5 U.S.C. 8901 et seq.) is the largest employer-sponsored group health insurance program in the world, covering more than 8 million federal employees, retirees, former employees, and family members. FEHBA Plans are contracts between the insurance carrier and the United States Office of Personnel Management (OPM). …

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Applying Collateral Source Statutes to ERISA after Wurtz

Applying Collateral Source Statutes to ERISA after Wurtz  By: David L. Place, J.D. Vice President, Director of Lien Resolution Services The U.S. Court of Appeals for the 2nd Circuit rendered a major decision on July 31, 2014 holding that New York’s anti-subrogation statute is “saved” from ERISA preemption. (Wurtz v. The Rawlings Company, — F.3d—,…

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Lien Resolution Success Story – Synergy utilizes its experience in resolving military liens and obtains full waiver from Tricare for a savings of $265,227

This is a case wherein a former service member was injured in a motor vehicle accident.  The injuries the plaintiff suffered left him wheelchair bound with a spinal cord injury.  Plaintiff’s counsel was able to obtain a policy limits settlement from the tortfeasor, but was confronted with a large Tricare claim. Tricare proved reluctant to provide…

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Lien Resolution Success Story – Synergy works directly with CMS Seattle Regional Office to shortcut the compromise process and reduce Final Demand by over $33,000

This is a case wherein the Medicare beneficiary was catastrophically injured in a Seattle, Washington motor vehicle accident. The beneficiary hired counsel and was able to obtain $1,000,000 in settlement funds. The settlement funds came via two separate settlements and when the first settlement was reported by the carrier to CMS problems began.  Plaintiff’s counsel attempted to resolve…

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Lien Resolution Success Story – Synergy splits hairs and uses McCutchen to achieve a series of reductions in the subrogation demand from an aggressive self-funded ERISA Plan

Synergy Lien Resolution Service was able to resolve a large series of subrogation claims being asserted in unrelated matters by a large, regional grocery store corporation. These were cases in which the plaintiffs were members of the corporation’s self-funded ERISA health plan, which has very strong recovery language. The corporation has a policy of aggressively prosecuting their subrogation/reimbursement…

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Lien resolution Success Story – Synergy’s reduces Medicare Final Demand by 47%, obtaining a refund of over $43,000 for the injured plaintiff

This case involved a Medicare beneficiary who was injured as a result of medical malpractice. When the plaintiff’s attorney settled the personal injury action, Medicare presented a Final Demand of approximately $91,000. The plaintiff’s attorney paid the Final Demand to avoid interest and then engaged Synergy Lien Resolution Services to appeal the amount of the Final…

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Lien Resolution Success Story – Synergy uses knowledge of MSP to reduce Medicare Final Demand by 74% in less than 60 days

This case involved a Medicare beneficiary who was injured in a motor vehicle accident. The beneficiary received medical benefits via Medicare Conditional Payments of approximately $25,000. When the plaintiff’s attorney settled the personal injury action, Medicare presented a Final Demand of approximately $16,500. The plaintiff’s attorney attempted to reduce this amount via a first level appeal…

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Lien Resolution Success Story – Synergy’s Medicare Post Final Demand Service secures full refund of $36,400 for injured plaintiff

This case involved a Medicare beneficiary who was injured as a result of medical malpractice. When the plaintiff’s attorney settled the personal injury action, Medicare presented a Final Demand of approximately $36,400. The plaintiff’s attorney paid the Final Demand to avoid interest and then attempted to reduce this amount via a first level appeal (Redetermination) but…

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Lien Resolution Success Story – Synergy’s aggressive lien resolution tactics result in an Air Ambulance lien waived and self-funded ERISA lien reduced by 86%

This case involved a serious slip and fall accident that happened on a cruise ship while it was at sea. The plaintiff suffered significant injures, incurring medical damages in excess of $540,000. The injured plaintiff engaged a seasoned trial attorney, but due to liability issues the plaintiff only received a fraction of the case value.  Following…

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Maryland Suspends Attorney for Failure to Repay Healthcare Reimbursement Claim

Maryland Suspends Attorney for Failure to Repay Healthcare Reimbursement Claim By: David L. Place, J.D. Vice President, Director of Lien Resolution Services Failing to deal with the subrogation/reimbursement claims of health insurance carriers has proven to be a possible career ending mistake for one Maryland personal injury attorney.  In the September 2013 Maryland Court of…

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AAJ Reinforces Our Message Regarding Medicare Set Asides

After announcing the withdrawal of the proposed rulemaking for Medicare Set Asides and proclaiming victory, AAJ has clarified the impact the withdrawal has on establishing set asides. According to the message sent out last Friday, the withdrawal has no impact on the statutory text of the Medicare Secondary Payer Act. Admittedly, the Medicare Secondary Payer…

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TESTIMONIALS

“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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