Medicare Lien Personal Injury Settlement

If you achieve a settlement for a client in a personal injury case who received Medicare benefits, there’s an additional layer of work to be done. That client will be required to use settlement funds to repay Medicare for the money spent on injury care. Depending on the amount, Medicare liens in personal injury cases can garner the entire settlement. So it’s not as simple as giving Medicare their due. The assistance of a group who understands the process of working with Medicare can be greatly beneficial to your client. The experts at Synergy Settlement Services have the knowledge and resources necessary to achieve a positive outcome when dealing with Medicare liens involving personal injury settlements.

Dealing with Medicare Liens in Personal Injury Cases

Personal injury cases involving Medicare can be particularly difficult because of Medicare’s lengthy process and inflexibility when it comes to settlements. First, Medicare must be notified if your client has been injured and requires medical care. If your client files a claim, but doesn’t notify Medicare that they were involved in an accident, they will be subject to fines. After your client receives medical treatment, Medicare will send a conditional payment letter, which lists all medical procedures that they have paid for. We will review this letter and contest any procedures that are unrelated to the personal injury claim.

Medicare will not reduce the amount of a Medicare lien placed on a settlement agreement; however, there are a few circumstances in which we can pursue waivers for your client. This includes:

  • If the probability or the amount of a recovery doesn’t warrant the pursuit of a claim, a waiver or a compromise may be established, according to the Federal Claims Collection Act.
  • If a waiver is in the best interests of the Medicare program, according to the Secretary of Health and Human Services.
  • If the lien is against a person without fault and would either defeat the purposes of Social Security or Medicare or would be against “equity and good conscience.”

About Synergy

For more than a decade, Synergy has worked with attorneys and their clients to provide innovative lien resolution services. We have the experience, contacts in key agencies, and the myriad of resources necessary to help your clients keep as much of their settlement as possible. Working with Medicare is an arduous, but necessary process. Let us handle this on behalf of your clients so that you can focus on core tasks.

For more information or to schedule a consultation, please submit our contact request form or call (877) 242-0022.

Disclaimer: The information contained in this article is for general educational information only. This information does not constitute legal advice, is not intended to constitute legal advice, nor should it be relied upon as legal advice for your specific factual pattern or situation.


“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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Understanding Structured Settlements and Medicare Set-AsidesThird Thursday Webinar Series

The parties agree that a Medicare Set-Aside is needed, now what? In this month's webinar, presented by Synergy CEO, Jason D. Lazarus, you will learn about the process basics for setting up a set aside including MSA allocations, funding mechanisms for set-asides, post-settlement administration as well as an overview of the process to make sure you close the case compliantly.

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