TOP 50 MOST UNREASONABLE HOSPITAL LIENS
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 …
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. …
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 …
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 …
Supreme Court Decides Nevils: FEHBA Subro – “Shall Supersede and Preempt any State or Local law”
On April 18, 2017 in Coventry Health Care Of Mo., Inc. V. Nevils the United States Supreme Court held that the subrogation/reimbursement plan language contained in the health insurance contracts of Federal Employee Health Benefit plans (FEHBA) preempted state law. …
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, …
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 …
Damages “shall” be in an amount double… Medicare Advantage Plans
On Monday, August 8th, the 11th Circuit affirmed the decision of the Southern District of Florida to award a Humana Medicare Advantage plan double damages when they were not repaid at the conclusion of a personal injury …
Is an Attorney Personally Liable to Repay Humana for Part C (Advantage plan) lien?
This case has gained national attention amongst the trial bar for its far reaching implications. Synergy is on the forefront of protecting plaintiffs and the plaintiff’s bar which is why we feel so strongly about how the court in this …
1024(b)(4) – Send It To The Right Place!
In Allena Burge Smiley v. Hartford Life and Accident Insurance Company, et. al, No. 15-10056 (11th Cir. 2015), the Eleventh Circuit reiterated what Synergy regularly advises clients to do regarding the statutory document request pursuant to 29 U.S.C. 1024(b)(4) …
