Medicare Gives Refunds? How Can My Client Get One?
Repaying Medicare for conditional payments can result in a reduced net recovery or no recovery at all for an injured Medicare beneficiary.
CUTTING EDGE INDUSTRY THOUGHT LEADERSHIP INSIGHTS
Synergy’s blog brings you the industry’s foremost thought leadership InSights on matters of healthcare lien resolution and Medicare Secondary Payer Compliance. Visit often to discover helpful InSights on important lien resolution compliance issues.
What is the SOL for Medicare Conditional Payments?
What is the statute of limitations for Medicare to institute an action for repayment of conditional payments used to be a question with more than one answer. In the past the Centers for Medicare and Medicaid Services (“CMS”) had argued that the six (6) year limitation period contained in the Federal Debt Collection Act for […]
Will Obamacare End ERISA’s Subrogation Tyranny?
By Dave Place, J.D., Director of Lien Resolution
In the wake of the disastrous holding in U.S. Airways v. McCutchen, 569 U. S. (2013) plaintiffs and their attorneys are crying out for an end to the Draconian tyranny of self-funded ERISA plans’ subrogation practices. As you may recall, Mr. McCutchen was severely injured, incurring nearly $67,000.00 in medical damages, in a motor vehicle accident that killed or seriously injured three (3) other people. Mr. McCutchen was able to recover $10,000.00 from the tortfeasor’s Bodily Injury coverage and another $100,000.00 from his own Under Insured Motorist coverage. Despite this six figure recovery, Mr. McCutchen was $867.00 worse off from having brought a claim due to paying attorney fees, litigation costs, and repaying the U.S. Airways self-funded ERISA plan. In light of this reality, the question being raised by so many is “will the Patient Protection and Affordable Care Act (“PPACA”) bring any relief?”
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Synergy out flanks Rawlings and reduces self-funded ERISA claim by 50%
Synergy negotiated directly with the Plan Administrator and within three (3) weeks had secured a reduction of 50% from Plan Administrator. This was savings of $13,334.59 to the injured plaintiff.
What In The World Is FEHBA And How Do I Deal With Their Reimbursement Claim?
The Federal Employees Health Benefits Act (FEHBA) of 1959 (5 U.S.C. 8901 et seq.) is the largest employer-sponsored group health insurance program in the world, covering more than 8 million federal employees, retirees, former employees, and family members. FEHBA Plans are contracts between the insurance carrier and the United States Office of Personnel Management (OPM).
Add the Administrative Services Agreement to your ERISA Document Request
An Administrative Services Agreement between a Plan Administrator and a Claims Administrator may fall within the purview of a document request under ERISA 29 U.S.C. § 1024(b)(4), with non-compliance subject to the penalty assessment authorized under ERISA 29 U.S.C. § 1132(c). As Synergy has long advocated, one of the keys to properly defending against an asserted subrogation or reimbursement claim from an ERISA plan is making requests to the plan administrator.
Synergy’s executive team brings an unparalleled amount of experience to assist you at settlement
Synergy allows trial lawyers to focus on what they do best. Our entire team is made up of experts who can help resolve the most complicated issues at settlement. Synergy’s executive team brings an unparalleled amount of experience to assist you at settlement.
Lien Res Success Story – Synergy use Medicare appeal process to secure a 100% reduction and $16,019.73 refund from MSPRC
Synergy successfully employed the Medicare appeals process and obtains a 100% reduction of Medicare’s Final Demand. After submitting consecutive appeals Synergy was successful in having MSPRC agree to reduce the demand amount to zero ($0.00) and issue a refund in the amount of $16,019.73.
Breaking Down Florida’s New Proposed Bar Rule on Lien Resolution Outsourcing
Recently there has been some confusion caused by the Florida Bar introducing subsection (E) to Rule 4-1.5(f)(4) and its application to non-lawyer lien resolution companies. Subsection (E) was approved by the FL Bar Board of Governors at their meeting on May 31st and the rule now awaits adoption by the Florida Supreme Court. The confusion, though not unexpected, is clearly resolved by a plain reading of the comment to this proposed amendment.