Hot off the press this morning from AAJ: As all of you are aware, the Centers for Medicare & Medicaid Services’ (CMS) implementation of the Section 111 reporting requirements of the Medicare Secondary Payer Act (MSP) for liability settlements and the penalties associated with improper lien resolution has created turmoil…
The United States Court of Appeals for the Eleventh Circuit has ruled that Medicare is not entitled to rely on its field manual and argue that a subrogation interest be reduced under a "made whole" type of analysis only if a judgment is entered in the case. In Bradley v.…
There are more and more tort cases arising after criminal acts, and one might forget that the State of Tennessee has subrogation rights to monies received in the later tort action. T.C.A. Section 29-13-113 grants the state a subrogation right in proceeds recovered by the victim in a later torts…
Dealing with Medicare on subrogation issues can be a nightmare. This bill, HR 4796, the Medicare Secondary Payor Enhancement Act, would help make things easier by requiring the Center for Medicare Services to respond to requests for their lien amount within 60 days.
A defense lawyer and I were having a drink the other day and he told me that from time to time he has difficulty getting cases settled at mediation because plaintiff’s lawyers don’t have information about subrogation interests. Here are some tips to avoid such problems: At the initial client…
From time to time I will see a question posted on the trial lawyers’ listserve asking whether Medicare has a subrogation interest in wrongful death proceeds. The answer is "yes," and this opinion helps explain why. Tennessee wrongful death law permits the recovery of medical expenses incurred between the injury…
Plaintiff’s lawyers: do you want to have the hell scared out of you? Read this article by Rick Swedloff on Medicare subrogation entitled "Can’t Settle, Can’t Sue: How Congress Stole Tort Remedies From Medicare Beneficiaries." The article appears in Volume 41.2 of the Akron Law Review. [A 2003 amendment to…
We all know that Medicare and Tenncare has a subrogation right in PI and wrongful death cases, but new information being sought by Medicare has lead some lawyers to believe that Medicare will now be looking at case proceeds for payment of future medical bills. The Medicare, Medicaid and SCHIP Extension…
The Tennessee Supreme Court has released its opinion in Health Cost Controls, Inc. v. Gifford, No. W2005-01381-SC-R11-CV (Tenn. S. Ct. Oct. 17, 2007). If the style of this case sounds you familiar you are not losing your mind – this case was before the Supreme Court on the made-whole four…
This decision from a federal judge in Pennsylvania will cause excitement throughout the tort bar: he ruled for a plaintiff who worked to protect assets from a claimed ERISA subrogation interest by having the proceeds of a settlement go from the defendant to a special needs trust. Law.com published this article…