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September 9, 2021 Rasa Fumagalli JD, MSCC, CMSP-F The American Bar Association’s Model Rules of Professional Conduct provide a blueprint for attorneys to follow when representing clients. The first Rule and arguably one of the most important ones, outlines a basic expectation in the client-lawyer relationship. Rule 1.1 states: “A lawyer shall provide competent representation to a client. Competent representation requires the legal knowledge, skill, thoroughness, and preparation reasonably necessary for the representation.” The Comments section of this Rule notes that competent handling of a particular matter includes “inquiry into and analysis of the factual and legal elements of the…
September 9, 2021 Samantha Webster Structured settlements may be used to fund a Workers’ Compensation Medicare Set-Aside (WCMSA). Samantha Webster, Synergy’s Director of Case Management, addresses two common questions that come up about funding of a WCMSA with a structured settlement annuity. 1. Are there different structured settlement options to fund a Medicare Set-Aside and what is the difference? Yes, there are different types of structured settlement payment plans that can fund a Medicare Set-Aside.  After an initial cash deposit is made to start the Medicare Set-Aside account (seed), a structured settlement will make annual payments to replenish/ add to…
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In Episode 17 of Trial Lawyer View, host TLV and Synergy CEO Jason D. Lazarus spoke with Mark Avera of Avera & Smith. They discussed how he went from working as a sheriff’s deputy to following in his father’s footsteps as a trial lawyer, his upcoming work with Trial School, and what he means when he says “Courage with hope.” They also talked about the impact that the Wiederhold v. Domino’s Pizza case had on him and his career, as well as his litigation against the tobacco industry. Learn more here. The post Synergy Blog first appeared on…
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  Teresa Kenyon, Esq. When handling a third-party liability case and you know your client had health insurance that paid the medical expenses, should you check to see if there is a lien interest on the settlement funds? Or maybe you have settled a case and you just received a notice letter from a possible lienholder, what do you do about it?  What about Medicare or other federally governed interests? Do you treat them differently?  These are critical questions to answer prior to disbursing funds to your client. To read more, download the article here.   The post Synergy …
July 23, 2021 Rasa Fumagalli JD, MSCC, CMSP-F The wait for proposed rulemaking related to Medicare Secondary Payer (MSP) compliance obligations regarding future medical services in liability settlements continues. Although the Department of Health and Human Services issued their initial notification of proposed rulemaking in the fall of 2018, the target date has been moved several times and is currently set for October of 2021. However, focusing solely on the notice of proposed rules will cause a practitioner to overlook the impact of important MSP compliance changes taking place with Section 111 Mandatory Insurer Reporting obligations on settlements. Current MSP…
Jason D. Lazarus, J.D., LL.M., MSCC, CSSC So, what do lawyers assisting Medicare beneficiaries do given all of the issues surrounding representing Medicare beneficiaries? To learn more, download the White Paper below: hbspt.enqueueForm({ portalId: 7609853, formId: “3a31fe03-41bd-4455-a882-0b33d31ec2d0”, target: “#hbspt-form-1626117993000-2780785632”, shortcode: “wp”, }); The post Synergy Blog first appeared on Synergy Settlements.…
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July 8, 2021 Rasa Fumagalli JD, MSCC, CMSP-F Most attorneys are well aware of the need to resolve Medicare’s conditional payments in connection with a client’s settlement. This obligation stems from the Medicare Secondary Payer (MSP) Act, 42 U.S.C. § 1395y(b)(2)(A)(ii), which prohibits Medicare from making payment for medical services when “payment has been made or can reasonably be expected to be made under a workers’ compensation law or plan of the United States or a State or under an automobile or liability insurance policy or plan (including a self-insured plan) or under no fault insurance.” 42 U.S.C. § 1395y(b)(2)(B)(ii).…
Medical bill from the hospital, concept of rising medical cost.
Michael Walrath, Esq. Introduction Plaintiffs’ lawyers largely understand settlement proceeds which are subject to a claim of lien must be protected in trust, even against the client’s interests or wishes. An attorney may not serve as the “sole arbiter” of a lien dispute, take it upon herself or himself to decide the dispute in the client’s favor, and distribute the disputed funds. Generally, liens must be amicably resolved or adjudicated at impasse. Perhaps the most misunderstood concept in the resolution of direct hospital/provider liens, is what I call the “lien debt dichotomy.” The lien debt dichotomy is simply a name…
Rasa Fumagalli JD, MSCC, CMSP-F The conditional payment recovery process in a workers’ compensation claim is not always smooth. Although the workers’ compensation insurance carrier will generally resolve any conditional payments in an accepted claim, the injured employee and counsel may find themselves in receipt of a post-settlement conditional payment notice or demand that identifies the injured employee as owing reimbursement to Medicare. This article will provide an overview of the conditional payment recovery process and identify ways to help you better navigate this process. The obligation to address conditional payments stems from the Medicare Secondary Payer Act. It prohibits…
May 11, 2021 Rasa Fumagalli JD, MSCC, CMSP-F The interplay between the Medicare Secondary Payer Act (MSPA) and Florida’s medical malpractice statute, Fla. Stat §§ 766.207 and 766.209 was addressed in the recent case of Gordon v. Azar, 2021 U.S. Dist.LEXIS 28314, (S. D. Fla. 2021).  The issue came before the Court in the context of the parties’ motions for summary judgment. The motions stemmed from Plaintiff’s medical malpractice claim against Northwest Medical Center (Northwest) involving his leg amputation on or about March 17, 2014. Plaintiff’s injury-related medical treatment was paid for by Medicare. The Medicare Secondary Payer Recovery Contractor…