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MedicareStructured Settlements

Settling Cases Where Liens Total More than the Gross Proceeds

By August 25, 2023No Comments

By: Lucia Giglia, Case Manager

One of the most common calls we receive from plaintiff attorneys is, “How do I settle this case when the lien amount significantly outweighs the value of the case?” There are a number of strategies that Precision Resolution can deploy to solve this problem for the plaintiff’s counsel, resulting in a meaningful settlement for the plaintiff.

In a recent case, a plaintiff was diagnosed with acute myelogenous leukemia as the result of toxic exposure and had ongoing extensive medical treatment. Therefore, the lien amounts continued to increase throughout the life of the primary case. This resulted in Medicare seeking over $629,326.86 in conditional payments, while a private insurer was seeking a reimbursement amount of $144,100.33.

After a thorough analysis of the case, Precision Resolution developed extensive arguments that established both a large number of unrelated treatments that had appeared on the lien itemization and grounds for Medicare to reduce its claim based upon an inequitable lien amount when compared to the settlement amount.

Accordingly, the private insurer reduced their final from $144,100.33 to $18,279.65, while Medicare (through both appeal and compromise request) agreed to reduce their demand to $93,852.19, saving the plaintiff over $661,000.00.

At Precision Resolution, of course, we monitor and remove all unrelated charges, but our efforts never end there.  In this case, we also submitted formal compromise requests which were granted.

The resulting reduction of the lien amounts by over $661,000 enabled the plaintiff the opportunity to recover a significantly higher amount of the proceeds and allowed our advisors to work with the plaintiff to establish a settlement preservation plan.