Synergy Blog

Preparing for the ERISA Lien Battle

February 11, 2021 Teresa Kenyon, Esq. The dreaded ERISA lien. The vendors representing ERISA self-funded health plans’ interests certainly want you to believe that it must be reimbursed in full. They will cite the US Airways v McCutchen case, tell you that they are not subject to equitable doctrines, and, therefore, do not have to…

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With Synergy’s Help, New York Times Exposes How Rich Hospitals Profit From Patients in Car Crashes

February 2, 2021 Synergy handles Hospital Lien disputes nationally on behalf of Trial Lawyers and their injured clients. Synergy’s Michael Walrath, Esq., as the nation’s leading authority on the nuances of state-specific hospital lien law and the facts underlying the “reasonable value” of hospital care, was tapped to assist investigative reporter Jessica Silver-Greenberg in her…

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Unraveling the Conundrum of Medicare Reimbursement

January 14, 2021 Rasa Fumagalli, JD, MSCC, CMSP-F Personal injury settlements involving Medicare beneficiaries will often have conditional payment claims by Medicare and/or Part C plan liens. Since accurate and complete information regarding Medicare’s payments may be unavailable during settlement negotiations, practitioners may find themselves engaged in guesswork. The confusion between Medicare’s interim and final…

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Book Bites: Confused by Medicare? Here’s a Helpful Overview

January 12, 2021 The Medicare program—and the related Social Security Disability Income/Retirement benefit (SSDI)—is one of the primary benefit programs available to those who are injured and disabled. Understanding the basics of this program is imperative to protecting the client’s eligibility for their benefits. Medicare and SSDI benefits are an entitlement and are not income…

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CMS Continues Push to Reduce Improper Payments Under the Medicare Program

December 10, 2020 Rasa Fumagalli, JD, MSCC, CMSP-F The Centers for Medicare & Medicaid Services (CMS) recently issued a press release announcing a steady decline in improper payments under the Medicare Fee-For-Service program over the past few years. The improper payment rate decreased to 6.27% in the fiscal year 2020, down from 7.25% in the…

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Liability Medicare Set-Asides: Where are we Today?

November 12, 2020 By: Rasa Fumagalli, JD, MSCC, CMSP-F The Centers for Medicare and Medicaid Services (CMS) has been slow in providing detailed guidance in the area of liability settlements that include compensation for future medicals. To date, the guidance consists of the May 2011 CMS Stalcup memo and the September 2011 CMS memo regarding…

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6 Real-World Considerations for Advanced Settlement Planning

November 10, 2020 Mrs. Smith was moved to the ICU and no neurologic monitoring was performed that evening after being moved from the surgical suite. The next morning, Mrs. Smith was found to be quadriparetic. A suit was brought against multiple defendants with a significant seven-figure recovery secured. Mrs. Smith and her family had Medicaid…

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What is a Medicare Set-Aside?

October 27, 2020 For many years, personal injury cases have been resolved without consideration of Medicare’s secondary payer status even though since 1980 all forms of liability insurance have been primary to Medicare. At settlement, by judgment or through an award, an injury victim would receive damages for future medical expenses that were Medicare-covered. However,…

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Discussing the Workers’ Compensation Medicare Set-Aside with your Client

October 21, 2020 By: Rasa Fumagalli, JD, MSCC, CMSP-F By now, most workers’ compensation practitioners are familiar with the Centers for Medicare & Medicaid Services (CMS) voluntary review process involving Workers’ Compensation Medicare Set-Aside Arrangements (WCMSA). CMS is currently willing to review settlements that exceed $25,000.00 in cases involving a Medicare beneficiary. Settlements that involve…

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How the Advent of the Mandatory Insurer Requirement Causes Problems for Lawyers

October 13, 2020 As of April 1, 2011, a Responsible Reporting Entities/insurers (RRE), (liability insurer, self-insurer, no-fault insurer, and workers’ compensation carriers) must determine whether a claimant is a Medicare beneficiary (“entitled”) and if so, provide certain information to the secretary of Health and Human Services (hereinafter “secretary”) when the claim is resolved. This is…

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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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