Archive for January 2022
Does an Insurance Company Automatically Have a Lien?
Subrogation rights are rarely absolute. But the process can be convoluted as you figure out whether federal law or state law governs your case’s health insurance liens. From Medicare to private liens here are some of the potential scenarios: Medicare → Federal law; Medicaid → State law (that is directed by a federal law in…
Read MoreState Law and Plan Language: What to Look for in Lien Resolution
Lien resolution starts with either a series of laws (like Medicare liens and Medicaid liens) or relies on plan language (like Private liens, ERISA liens, and more). For private liens, there are tens of thousands of different plans based on different state laws and different contracts – or plan language. If you know how…
Read MoreMAJ’s Virtual Lunch and Learn, Featuring MASSIVE’s COO Ryan Weiner Tomorrow on January 26, 2022
Grab your laptop and lunch and join MASSIVE’s COO, Ryan Weiner tomorrow at 11:30 a.m. ET as he discusses how to handle Michigan’s No-Fault Reform. If you’re a Michigan attorney and wondering how to properly investigate and resolve the many insurance liens possible with the PIP structure, then you won’t want to miss MAJ’s virtual Lunch and Learn. Register today and we’ll see you tomorrow!
Read MoreWhat is a “Non-Submit” or “Evidence-Based” MSA?
Medicare Set-Asides are a specialized product where Medicare has set forth a special process. The general idea is that an MSA will pay for medical care related to sued-for injuries so that Medicare doesn’t pay. But what happens when the MSA industry decides it wants to cut Medicare from the approval process? Medicare says…
Read MoreAnti-Subrogation: When Health Insurance has no Lien Right
Subrogation rights can be limited by state law. In fact, eight states are considered “Anti-Subrogation” states with one more effectively anti-subrogation. Those states are: Arizona Connecticut Kansas Missouri New Jersey New York North Carolina Virginia Georgia* – essentially anti-subrogation through a strong made whole doctrine that cannot be overridden by contract language Most simply,…
Read MoreMedicare Suggests LMSAs and NFMSAs are on the Horizon. Again.
Medicare via HHS/CMS has once again put us on notice that Medicare Set-Asides may expand to liability and no-fault scenarios with LMSAs and NFMSAs. It recently released a Notice of Proposed Rule Making with a due date of February 2022. You can find the NPRM here. Could that mean CMS will finally create rules…
Read MoreMedicare Set-Aside Basics
Medicare Set-Asides (or “MSAs”) are a construct created because the Medicare Secondary Payer Act makes it illegal for Medicare to pay for case-related treatment. Of course, this is limited to circumstances where a primary payer exists, such as a Workers’ Compensation carrier, a No-Fault carrier, or a liability defendant. But MSAs don’t exist under the law. They…
Read MoreMASSIVE’s Ryan Weiner Presenting at the RISE Medicare Secondary Payer Master Class February 25, 2022
Ryan Weiner, COO of MASSIVE and long-time authority on liability, no-fault, and workers’ compensation conditional payments, will be speaking at The 7th Annual RISE Medicare Secondary Payer Master Class on February 25 at 9:00 a.m. (EST) at the Kimpton Hotel Monaco in Washington DC. Ryan will be co-presenting “Understanding the Obligations of Plaintiff/Lawyer Related to No-Fault Conditional Payments”. Key content includes: Examine the…
Read MoreHow Many Files Can Medicare Open for One Lawsuit?
Most lien holders have one file for all of an individual plaintiff’s settlements. Medicare can have multiple for each of an individual plaintiff’s settlements. Medicare’s process has its roots in something called Section 111, or Mandatory Insurer Reporting. That law requires all defendants notify Medicare of payments they make, whether they are paying voluntarily…
Read MoreMedicare’s Agents: CMS, BCRC, and CRC
For Medicare Liens, the agency is represented by one branch of the government and two contractors. Those actors are: CMS – the Centers for Medicare and Medicaid Services. CMS is the government agency involved in Medicare Liens and works beneath Health and Human Services of the Executive Branch; BCRC – the Benefit Coordination & Recovery…
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