Effective ERISA Lien Reduction Strategies
Navigating ERISA liens can be a daunting task, given the complexity of the Employee Retirement Income Security Act (ERISA) and its impact on self-insured health plan reimbursement.
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.
Navigating ERISA liens can be a daunting task, given the complexity of the Employee Retirement Income Security Act (ERISA) and its impact on self-insured health plan reimbursement.
Combating an ERISA lien on a personal injury settlement requires a thorough understanding of both the specific plan language and applicable contract law principles.
Effectively minimizing or eliminating the reimbursement of any claimed medical lien is a critical part of ensuring just compensation for the injured.
Liens can become a legal labyrinth which negatively impacts the amount your injured clients will receive. This is precisely why collaborating with a dedicated Lien Resolution Specialist can be a game-changer for your practice.
Self-funded ERISA plans are becoming more and more aggressive about asserting their reimbursement rights when one of their members has settled a pi claim.
You might ask yourself, why hire experts to assist with outsourcing lien resolution when I can do it myself.
December 6, 2021 By: Teresa Kenyon, Esq. In HMS Holdings LLC v Ted A Greve & Associates P.A. et al, 2021 WL 5163308, an ERISA self-funded health plan was denied a temporary restraining order (TRO) on settlement funds. The court found that the health plan did not present sufficient evidence to satisfy all necessary requirements […]
August 12, 2021 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 […]
Most, if not all, ERISA health insurance plans state that injuries caused by a liable third party are not a covered expense and require reimbursement when a plan pays for injury-related medical expenses (often referred to as subrogation clauses). ERISA provides that health plans which qualify under its provisions can bring a civil action under section 502(a)(3) to obtain equitable relief to enforce the terms of the plan. Appropriate equitable relief is really the only enforcement mechanism an ERISA plan can utilize to address its reimbursement rights contained in the plan.