Medicare Advantage Plan Reimbursement Claims in PI Settlements
Clients enrolled in Medicare Advantage plans have a different recovery process than those on Original Medicare. Firms that run every Medica…
Category
Liens & Settlement
Medical liens, Letters of Protection, ERISA/MSP reductions, and settlement-distribution mechanics.
The Common Fund Doctrine: Making Lienholders Share the Cost of Recovery
Lienholders benefit from the plaintiff's fee-funded recovery. The common fund doctrine, where it applies, forces them to share pro rata in…
ERISA Liens in Personal Injury Settlements: Preemption, the Montanile Defense, and How to Negotiate a Reduction
When a plaintiff's health coverage is provided through an employer-sponsored ERISA plan, the plan's subrogation and reimbursement clause is…
Workers' Comp Medicare Set-Asides: CMS Review Thresholds, Minimization Strategy, and Administration Options
A workers' compensation Medicare Set-Aside protects Medicare's future interests when a comp case settles and the injured worker is a Medica…
Lien Recovery Against a UIM-Only Settlement After Arbitration
A UIM-only recovery is not a third-party settlement, and treating it like one hands money to lienholders who may have no claim to first-par…
Pre-Settlement Litigation Funding in PI Cases: Repayment Rights, Disbursement Obligations, and Ethical Limits
When a PI client takes a pre-settlement advance from a litigation funder, the funder's contractual repayment right becomes part of the disb…
Competing Lien Priority at PI Settlement: Who Gets Paid When Proceeds Run Short
When a PI settlement cannot satisfy all liens against the recovery, priority rules determine the payout order and can leave some lienholder…
State Hospital Lien Statutes and Letter of Protection: Navigating the Competing Claims at Settlement
Most states have enacted hospital lien statutes that give hospitals a direct lien against a tort recovery for emergency and acute care serv…
Dual-Eligible Clients and the Double Lien Problem: Coordinating Medicare and Medicaid at PI Settlement
When your client receives both Medicare and Medicaid benefits, two separate federal and state conditional payment interests arrive at settl…
Non-ERISA Group Health Subrogation: When State Law and the Made-Whole Doctrine Apply
Not every group health plan is ERISA-governed. When the insurer is a fully insured, state-regulated carrier rather than a self-funded emplo…
Medi-Cal Reimbursement in California PI Settlements: DHCS Claims, Reduction Strategies, and Disbursement
California's Medi-Cal program asserts a reimbursement claim in personal injury settlements that is governed by Welfare and Institutions Cod…
Comp and PI Together: Which Case to Close First and Why It Matters
When your client has both a workers' comp claim and a third-party PI case, the order you settle them decides who eats the credit and how mu…