Resolving Medicare Liens

Resolving Medicare Liens in Personal Injury

If you are an attorney working on a personal injury case hoping to obtain that crafty Medicare lien resolution then you already know that this is among the more frustrating legal experiences you can participate in. Perhaps the only thing more frustrating is that Medicare will delay your client’s settlement check at the end of the case if the final demand has not been reached.

Taking the following logical steps and putting them into action can guide you in the right direction regarding obtaining that lien resolution for your client.

Gather Resources and Set Expectations

When first meeting your client, make sure you learn as much as you can about their Medicare situation including if they receive benefits or communicate with Medicare. After speaking with them, make copies of any of these relevant items. Keep in mind that clients are typically impatient when it comes to wanting their settlement money. It’s important that you set their expectations low and inform them that Medicare moves at a snail-like pace and that it will be a long process to get to the finish line.

Notify Medicare A.S.A.P. and Act Accordingly

The quicker you provide the three major pieces of relevant information (beneficiary, case, and representative) to Medicare the less painful the process is. Eventually, the Medicare Secondary Payer Recovery Center (MSPRC) will send you the Rights and Responsibilities letter which will be your guideline through the settlement process. Submit your Proof of Representation to MSPRC and they should issue a Conditional Payment Letter within 65 days. This letter should include all the finances Medicare includes for your case. However, you will need to closely examine it as it will likely have some unrelated medical listings not related to your case.

Settle the Case

After reviewing the conditional payment letter and monitoring the case, you will eventually reach your settlement and need to contact MSPRC to divulge the relevant settlement info including: settlement amount, attorney’s fees, liability insurer information, and a copy of the settlement agreement. This information will determine Medicare’s final demand amount. After eventually receiving the demand, pay Medicare their amount owed and determine whether or not to appeal the final demand if necessary.

Obtaining a Medicare lien resolution can be a long and arduous process. If you cooperate with Medicare by quickly submitting all relevant documents and communicate well with your client, you should at least reduce some of the hassles of a lien resolution.

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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