Category Archives: LIENS

The Most Common Types of Mass Tort Cases Part 1

When a group of individuals (claimants) encounter a similar harmful experience that was the result of the actions of the same entity (defendant), this can result in either a mass tort case or a class action lawsuit. Both of these legal actions are designed to assist legal counsel with representing these individuals by grouping their…

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Ignore Medicare’s recovery rights at your peril! Plaintiff firm settles with the U.S. Government for inadequately addressing and repaying Medicare Conditional Payments.

On June 18, 2018, the U.S. Department of Justice’s Attorney’s Office for the Eastern District of Pennsylvania announced a recently concluded settlement with a plaintiff firm involving the repayment of Medicare Conditional Payments.  The government’s investigation arose under the Medicare Secondary Payer provisions of the Social Security Act, which authorizes Medicare, as a secondary payer,…

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Increasingly trial attorneys are discovering that settlement of a personal injury or wrongful death claim with the tortfeasor can be the beginning not the end of negotiations or even litigation. Once settlement funds are received, the often-protracted lien resolution process begins, especially hospital liens. Hospitals typically demand reimbursement of their full, undiscounted list prices for…

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Medicare Lien Surprise: Don’t Ever Rely on a Conditional Payment Letter

An intriguing case, Mayo v NYU Langone Med. Ctr., just came out of the Supreme Court of New York, reminding the trial bar that when resolving a conditional payment for a Medicare beneficiary only the “Final Demand” letter is final.  Reliance upon a “Conditional Payment Letter” (CPL) is inappropriate.  The Mayo case revolved around whether…

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ERISA Liens – Back to the Basics

ERISA is a very complex federal statute that has been interpreted very negatively for personal injury victims by the United States Supreme Court. The goal of this blog post is to explain ERISA and its impact when settling case in a very simple way. Key takeaways: ERISA is a federal statute that protects self-funded employer-based…

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Ahlborn is Alive & Well

Since the landmark decision by the US Supreme Court in Arkansas Department of Health and Human Services v. Ahlborn in 2006, state Medicaid agencies have grappled with how to recover monies spent for injury related care through their third party liability statutes without violating the Ahlborn decision.  Many states continued to apply third party recover…

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Limitations on Hospital/Provider Liens When the Plaintiff is on Medicare

One of the most difficult issues trial counsel must resolve involves addressing hospitals/providers liens for Medicare clients.   Recently the Centers for Medicare and Medicaid Services (CMS), via the Medicare Learning Network (MLN), released policy memo SE17018 which provides excellent and concise answers to most of these issues. This memo addresses when a hospital/provider should bill,…

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Supreme Court Rejects Change in Lien Res. Outsourcing

After nearly five years, on October 6, 2016, the Florida Supreme Court issued Opinion SC16-104 and declined to make any change to the existing Rules Regulating the Florida Bar in relation to lien resolution outsourcing. As Florida’s trial attorneys know, the issue of whether there was a need for a change in the existing rules…

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Medicare Reduces Reporting Threshold from $1,000 to $750

Medicare has reduced the threshold for when a physical trauma-based liability settlement is large enough that the beneficiary needs to report it and repay conditional payments. On November 15, 2016, the Centers for Medicare & Medicaid Services (“CMS”) issued an alert which decreased the current reporting threshold from $1,000 to $750. The threshold decrease is…

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Anti-Subrogation Beats FEHBA

On May 3, 2016 the Supreme Court of Missouri, sitting en banc, once again sided with the injury victim, and reason. Upon remand from the United States Supreme Court, the Supreme Court of Missouri refused to give Chevron deference to the recent self-serving rule change by the Office of Personnel Management (OPM) (referring to Chevron…

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JUSTICE SERVED! McCutchen Gets Final Victory Over the ERISA Plan

On March 16, 2016, the Western District of Pennsylvania sounded the final note in the saga that was the McCutchen case. Thankfully it vindicated the now deceased James McCutchen. The Western District Courts’ ruling spoke to several points raised by the parties, but the “common fund” issue is of particular importance. The court ruled, much…

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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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