Posts Tagged ‘right of reimbursement’
Medicare Reimbursement: What Happens When You Overpay Medicare?
In a personal injury lawsuit, there is a health insurance carrier responsible for health care bills. If your client is covered by Medicare at the time of your injury you must report the injury to Medicare and your client will likely owe them for part of that care. If you happen to overpay Medicare during…
Read MoreMedicaid Liens Reduced by $550,000
Medicaid wanted to take 100% of a quadriplegic plaintiff’s settlement. Attorney George Fishback tasked MASSIVE with reducing Medicaid’s two liens. We stepped in and reduced over $550,000.00 of those Medicaid and Managed Medicaid liens, allowing the injured plaintiff to keep 88% of his settlement after attorney’s fees! At MASSIVE, our expert attorneys know how…
Read MoreMed Lien Supports the Michigan Association for Justice Annual Convention
Massive is a long time supporter of the Michigan Association for Justice, and we are excited to be exhibiting at the Annual Convention May 11-12, 2018! Massive is the country’s most accurate and reliable lien resolution company. We resolve liens with Medicare, Medicaid, Private Insurance, ERISA, Military and VA. We save firms time by removing the frustrating lien resolution process. Massive…
Read MoreCMS Begins Teaching Providers About MSAs
CMS issued MLN Matters Number SE17019 on September 19, 2017. Its three pages have one clear intent: teach medical providers how to discover whether they should bill Medicare or the patient’s MSA account. Click here for the full text of MLN Matters Number SE 17019. The article concludes with a section called, “Provider Action Needed.”…
Read MoreLiens without Plan Language
Lien resolution often starts with one question: What does the plan language say? More specifically we ask if the private insurance lien (or even the ERISA lien) has contract language explaining its rules for subrogation and liens. Every once in a while we find lien holders and health insurers who tell us there isn’t plan…
Read MoreAnti-Subrogation States – Defeating a Lien Before it Exists
Sometimes, a lien never has to exist. Sometimes, the insurance company never stands a chance. And sometimes, a client keeps 100% of her net settlement. These times are most often settlements in anti-subrogation states – or states that statutorily refuse to allow subrogation, liens, or insurance reimbursement. The eight officially anti-subrogation states are: Arizona Connecticut…
Read MoreFEHBA Liens Now Mimic ERISA Liens
On April 18, 2017, the United States Supreme Court ruled in Coventry Healthcare of Mo., Inc. v. Nevils that reimbursement or subrogation plan language in Federal Employee Health Benefit Plans (FEHBA) preempts any State law. This holding means that FEHBA liens now feel a lot like ERISA liens. Since the McVeigh ruling in 2006, there has…
Read MoreAre Self-Funded ERISA Plans All That Scary?
The short answer is – they can be. But if you know how ERISA Plans operate you can achieve maximum reductions. Resolving liens can be a difficult and time-consuming task. Medicare frequently includes unrelated claims, but is statutorily required to reduce by a pro-rata share of attorney’s fees and costs. Insured health plans typically reduce…
Read MoreMedicare Liens Are Limited
Two weeks ago, a California District Court ruled that Medicare can only seek reimbursement for items and services related to the underlying claim. Logical? Sure. But there’s more to it! First, the Court took on Medicare’s combination of ICD-9 or ICD-10 codes into one payment. Second, the Court reminded us all that Medicare’s claim is…
Read MoreMontanile: An Option to Defeat ERISA Liens
Plaintiffs finally have their ERISA victory. With the increasing power the U.S Supreme Court has given to self-funded ERISA Plans, its decision in Montanile v. Board of Trustees of National Elevator Industry Health Benefit Plan, 136 S. Ct. 651 (2016) was a welcome surprise for plaintiffs. Prior to Montanile, beneficiaries had to rely on an…
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