You might ask yourself, why hire experts to assist with lien resolution when I can do it myself. You also might ask whether it is ethically permissible to outsource lien resolution to a lien resolution company. The first question is quite simple to answer and the second one requires a little more examination of the rules regulating lawyers.
The problem really starts with the responsibilities a law firm has at the beginning of each new case as it pertains to liens. I use lien synonymously with subrogation, reimbursement, and debts here even though there are differences. Given the law, a law firm must track liens that are asserted against their client’s personal injury claim and in some instances will have an affirmative duty to investigate and identify possible liens (Medicare & Medicare Advantage plans are good examples).
The law firm must determine whether a lien holder’s claim has merit and is legally valid. To reach resolution, this requires a law firm to have significant contact and interaction with a variety of lien holders along with recovery vendors. At the conclusion of the case, it frequently requires protracted negotiations to reach an agreement to resolve the claims made by a lien holder or recovery vendor against a settlement, judgment, or verdict. The bigger issue, given the distractions it creates, is that law firms frequently wait too long to begin to negotiate a reimbursement to a lien holder which can delay disbursement to the injury victim. All the foregoing creates pressure on law firms to outsource lien resolution functions.
On March 8th, 2023, Daniel Tsai (Deputy Administrator and Director of CMS) sent a letter to all state Medicaid agencies providing guidance related to changes in third-party liability (TPL) requirements based upon the holding in Gallardo v. Marstiller. The Supreme Court’s ruling in Gallardo v.…
By Guest Author Kevin E. James, Esq. – Lien Resolution Attorney The Medicare Secondary Payer Act (MSP) has often been described by many courts as notoriously “complex”. This complexity has only increased as Medicare Advantage Organizations (MAO) have increasingly become more litigious in attempts to…
By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC While much more attention is paid to Medicare, ERISA and other lien types, federal reimbursement rights of military programs should be on a trial lawyer’s radar. With a rise in those serving in the US military abroad…
By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC In this post, you will get an overview of common issues that arise when representing clients who have healthcare coverage by virtue of their employment with the federal government. For federal workers, they get their coverage through…
By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC Some clients, post-accident, may have switched over to a Part C Medicare Advantage Plan. Therefore, even if you have gone through the resolution process for your client and gotten the Medicare conditional payment related issues dealt with…
By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC In this post, we now turn our attention to Medicare Conditional Payments and resolution of those obligations. Congress has given the Centers for Medicare and Medicaid Services (hereinafter CMS) both subrogation rights and the right to bring…
By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC For clients who are on Medicaid, they will most likely have a Medicaid lien when their case is settled. When Medicaid has made payments for medical expenses related to an injury, it may assert a lien against…
By Jason D. Lazarus, J.D., LL.M., MSCC, CSSC Although a deep dive into ERISA law and liens is beyond the scope of this article, this will give you an overview and a starting point. The Employee Retirement Income Security Act was passed by Congress and…
By Jason D. Lazarus, J.D., LL.M., MSCC You might ask yourself, why hire experts to assist with lien resolution when I can do it myself. You also might ask whether it is ethically permissible to outsource lien resolution to a lien resolution company. The…
