Hospital Liens and the Reasonable Value of Care
The “reasonable value” of healthcare is an issue throughout our entire system and there’s no definition of what is “reasonable value”.
Tag: Lien Resolution
Is the PAID Act the Solution for Locating Hidden Medicare Advantage Liens?
The PAID Act has the potential to make it easier to locate these hidden liens. The risk of not finding them is a private action by the Medicare Advantage plan for double damages.
ERISA Plan Denied Temporary Restraining Order, No Imminent Harm
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 […]
Teresa Kenyon on TLV Podcast
In Episode 16 of Trial Lawyer View, TLV host and Synergy CEO Jason D. Lazarus had an insightful conversation with Teresa Kenyon, Director of Lien Resolution Services at Synergy Settlement Services. The episode focused on Teresa’s journey in the legal industry, particularly her transition from personal injury law to subrogation law, and how she ultimately […]
Hospital “Liens” vs. “Debts”: A Distinction with a BIG Difference
May 13, 2021 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 […]
Hospital Liens Carry Ethical and Legal Obligations
April 22, 2021 Michael D. Walrath, Esq. Direct provider “liens” against settlement proceeds have teeth, whether hospital or physician liens, statutory or contractual. The various positions of state bar associations on these issues, and the limited law delineating them, have historically been ever shifting and evolving but two things are clear. Liens must be released […]
Reducing Medicaid Liens: Why Was the Ahlborn Case Such a Significant Victory for Injury Victims?
Heidi Ahlborn was injured in a very serious car accident in January of 1996. At the time, she was a nineteen-year-old college student pursuing a degree in teaching. She suffered a catastrophic brain injury that left her incapable of finishing college and unable to care for or support herself in the future. When the Arkansas Department of Health tried to assert a lien against Ahlborn’s settlement, she sued, and the case went all the way to the Supreme Court, who found in her favor.
What are Your ERISA Plan’s Recovery Rights?
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.
Preparing for the ERISA Lien Battle
February 11, 2021 Teresa Kenyon, Esq. The dreaded ERISA lien. The vendors representing ERISA self-funded health plans’ interests certainly want you to believe that it must be reimbursed in full. They will cite the US Airways v McCutchen case, tell you that they are not subject to equitable doctrines, and, therefore, do not have to […]