Lien Resolution Services

We put the pieces of the puzzle together.

maps LIEN RESOLUTION SERVICES (LRS) assists attorneys and adjusters in complying with medical lien obligations (lien searches/disputes/appeals) and in the case of Medicare, future medical allocations or Medicare Set Asides (MSAs).  LRS’ experienced team, led by Roger Larue, J.D., M.B.A., has assisted in medical lien and allocation matters for individual (single event) cases and Class Action/Mass Torts. Mr. Larue has published several articles and is a concerned industry leader.

 

MEDICARE and MEDICAID, et al SECONDARY PAYER ACT

WHAT YOU SHOULD KNOW
As one of the United States Courts of Appeal recently observed, the Medicare Secondary Payer Act “is not a model of clarity. Yet, it does clearly provide that, where there is some entity, other than Medicare, obligated to pay for an item or service, that entity shall pay first and Medicare shall pay the excess.” CMS is constantly changing its interpretation of the U.S. Code, the Code of Federal Regulations, and in general how to protect Medicare’s interest.

WHAT YOU SHOULD CONSIDER

As Defense

Defendants may be liable for up to three years, if the plaintiff doesn’t use his settlement funds in compliance with the MSP Act. Further, the MMSEA §111 reporting requirements will give CMS the ability of an immediate cross check if Medicare beneficiaries spend their allocated funds in violation of the MSP Act.​

As Plaintiff

CMS has interpreted the MSP Act to require that funds must be used for medical expenses that are Medicare-allowable and related to the injury. Some courts have held that plaintiff’s attorneys are responsible for up to six years from the time they receive the judgment/settlement funds.​

As Claimant

CMS has stated that the entire settlement amount could be at risk if an MSA (approved or not approved) is not properly administered.