Synergy’s blog brings you the industry’s foremost thought leadership InSights on matters of healthcare lien resolution and Medicare Secondary Payer Compliance. Visit often to discover helpful InSights on important lien resolution compliance issues.
In a well reasoned opinion, the Florida Supreme Court has overtuned the unfair medical malpractice caps. These caps devalued human life as children and seniors who were not breadwinners, could be the victim of malpractice with no real ability for family members to recover damages. We applaud the Florida Supreme Court’s opinion in the McCall […]
Unfortunately, as part of the budget signed by President Obama on the 26th of December (Merry Xmas), a legislative fix for Ahlborn was made law. Now, Medicaid liens are like Medicare liens in the sense that they are super liens. Medicaid will be able to assert its lien against the entirety of the settlement instead […]
At Synergy, we spend a lot of time in mediations helping attorneys and their seriously injured clients to plan for their post settlement future. We try to create holistic settlement plans that meet our client’s needs while taking the least possible amount of risk. The majority of financial products in the settlement industry are fixed income or fixed interest products.
As has been well publicized, it was revealed last week on healthcare.gov that fewer than 27,000 people signed up for private health insurance last month in the 36 states relying on a problem-filled federal website. States running their own enrollment systems signed up more than 79,000, for a total enrollment of just over 100,000.
Even more concerning then the technological challenges with the system, is whether consumers have the necessary knowledge of health insurance to be making these decisions by January 1, 2014. According to poll results released in August 2013 by the American Institute of CPAs, more than half of Americans are not equipped with the rudimentary knowledge of health insurance concepts and definitions to understand the basics of health insurance plans. Read more ….
Repaying Medicare for conditional payments can result in a reduced net recovery or no recovery at all for an injured Medicare beneficiary.
By Dave Place, J.D., Director of Lien Resolution
In the wake of the disastrous holding in U.S. Airways v. McCutchen, 569 U. S. (2013) plaintiffs and their attorneys are crying out for an end to the Draconian tyranny of self-funded ERISA plans’ subrogation practices. As you may recall, Mr. McCutchen was severely injured, incurring nearly $67,000.00 in medical damages, in a motor vehicle accident that killed or seriously injured three (3) other people. Mr. McCutchen was able to recover $10,000.00 from the tortfeasor’s Bodily Injury coverage and another $100,000.00 from his own Under Insured Motorist coverage. Despite this six figure recovery, Mr. McCutchen was $867.00 worse off from having brought a claim due to paying attorney fees, litigation costs, and repaying the U.S. Airways self-funded ERISA plan. In light of this reality, the question being raised by so many is “will the Patient Protection and Affordable Care Act (“PPACA”) bring any relief?”
Read more ….
What is the statute of limitations for Medicare to institute an action for repayment of conditional payments used to be a question with more than one answer. In the past the Centers for Medicare and Medicaid Services (“CMS”) had argued that the six (6) year limitation period contained in the Federal Debt Collection Act for […]
Synergy negotiated directly with the Plan Administrator and within three (3) weeks had secured a reduction of 50% from Plan Administrator. This was savings of $13,334.59 to the injured plaintiff.
The Federal Employees Health Benefits Act (FEHBA) of 1959 (5 U.S.C. 8901 et seq.) is the largest employer-sponsored group health insurance program in the world, covering more than 8 million federal employees, retirees, former employees, and family members. FEHBA Plans are contracts between the insurance carrier and the United States Office of Personnel Management (OPM).