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Paraquat Litigation in 2025: Key Updates and Challenges
The Paraquat multidistrict litigation (MDL) continues to evolve, with significant developments shaping the trajectory of…
Law Firm
Frequently Asked Questions
How long does the lien resolution process take?
The process can take anywhere from two to nine months, depending on what agencies are involved.
What is the typical timeline for lien resolution?
Estimated timelines depend on LitPRO’ s receipt of complete, accurate information, settlement allocations, and appropriate authorizations. LitPRO updates timelines and manages expectations as our work proceeds.
Why are you reporting a date of injury before the date my client became eligible for Medicare benefits?
In cases involving exposure, ingestion, or implantation, we are required to report the date of loss or injury as the initial date of claimant exposure. Medicare is entitled to recover from the date of exposure (or the first date of entitlement if it occurred after the date of exposure) up to the settlement date.
If exposure ended before December 5, 1980, Medicare does not have the right to recover. In such instances, a “No Interest” letter is issued promptly on receipt of the complaint or other documentation validating the final date of exposure.
There are still charges on Medicare’s final demand that are not related to the case. What are our options?
LitPRO is well-prepared to leverage the three levels of appeal at our disposal. The first level of appeal is managed internally by the team responsible for issuing the Final Demand, and it frequently confirms the initial decision. The subsequent two levels of appeal involve external contractors; the third level involves an Administrative Law Judge (ALJ) hearing. Both levels of appeal beyond the initial stage have demonstrated higher rates of success.
Before initiating each level of appeal, LitPRO consults with the firm to deliberate on a strategic approach and determine whether additional information is required.
The charges on Medicare’s demand are related, but it is taking an inequitable portion of my client’s settlement. What can we do?
Three distinct avenues exist for securing additional lien reductions in this scenario: Pre-Settlement Compromise, Post-Settlement Compromise, and Waiver.
- Pre-Settlement Compromise: LitPRO provides the proposed settlement amount, enabling Medicare to contemplate a compromise of their lien to facilitate the claimant’s acceptance of the settlement. If the final settlement deviates from the proposed amount, the compromise requires reassessment with Medicare. Payment within 60 days of funding is mandated by Medicare.
- Post-Settlement Compromise: After receipt of Medicare’s final demand, an equitable division of the settlement funds may be considered. Payment must be made within 60 days of the final demand, and a refund is disbursed upon the successful conclusion of the compromise decision.
- Waiver: Differing from compromises, Medicare resolves waiver requests based on the financial hardship endured by the claimant or their dependents. The submission of a form outlining the claimant’s assets and expenses is necessary after receipt of the final demand. Despite a successful waiver decision, the final demand must be paid within 60 days, and then a refund is issued.
Additional Settlement: It is crucial to note that compromises and waivers are not deemed full and final in the event of an additional settlement.
Can I have my client reach out to Medicare or Medicaid to help speed up the process?
We highly recommend that claimants refrain from direct outreach to lienholders, as LitPRO’s dedicated contacts are typically situated in a distinct department, separate from general call center operations. Engaging directly with the call center may result in the receipt of inaccurate information. It is essential to inform your clients that they may indeed receive correspondence from these agencies. However, it is imperative to emphasize that LitPRO is concurrently receiving and diligently addressing all relevant correspondence. For seamless coordination and resolution, we encourage the forwarding of any received correspondence to LitPRO for management.
My client says they were never on Medicare or Medicaid benefits. Why do they have to be submitted?
Medicare and Medicaid serve as mandatory notice agencies; as a best practice, LitPRO strongly advises verifying this information. Submitting the necessary documentation to Medicare/Medicaid ensures compliance with the notification obligation, and these agencies issue clearance if the claimant is not entitled to their benefits.
How does Medicare handle wrongful death actions?
When a person covered by Medicare receives a settlement or judgment related to a wrongful death claim, Medicare may have a right to recover any conditional payments it made for medical expenses related to the injury that led to the wrongful death.
Medicare will typically follow the state statutes to determine if medical payments are recoverable in Wrongful Death actions. It’s important to review the state statutes regarding Wrongful Death and understand that Medicare requires documentation showing what was pleaded, claimed, and released in the settlement in addition to the state recovery rules. If allocations to Wrongful Death are not made based on the merits of the case and approved by a Judge, Medicare may not reduce their recovery even in states where medical payments aren’t recoverable for Wrongful Death actions.
Claimant
Frequently Asked Questions
What is a healthcare lien?
Your health insurance may have paid for the injury-related care that is part of your lawsuit. Some health insurers have a right to be reimbursed for those payments, with the reimbursement coming out of your personal injury settlement. This right to reimbursement can be based in either statute or the contractual language in your policy.
When your health insurance pays for medical bills caused by a third party, it suffers an economic loss. As a result, your health insurance may claim a “lien” against the third party, just like you do. However, that claim shifts to you once you receive money from the third party, because you received compensation for the medical bills your insurer paid.
What could happen if I don’t address my healthcare lien?
Depending on the type of healthcare lien, failure to resolve reimbursement obligations could result in the suspension of your healthcare coverage, financial penalties, and/or a potential lawsuit against you.
What is a Lien Resolution Administrator (LRA)? Who is LitPRO?
In complex litigation, it is common for law firms to engage the expertise of a thirty-party company that specializes in healthcare lien resolution. This company, referred to as the Lien Resolution Administrator (LRA), is tasked with reporting cases to the relevant lienholders, auditing claims listings, and finalizing liens to ensure compliance with statutory and contractual law. LitPRO is the company your attorney has engaged to perform this work in this litigation.
Why am I getting letters from CMS?
Medicare-entitled claimants receive a copy of a Medicare Rights & Responsibilities letter, stating that CMS was notified that you filed a liability insurance claim on their behalf. The letter confirms that a Medicare Secondary Payer (MSP) recovery case has been established, and it goes on to explain the concept of conditional payments made toward the injury-related care. Medicare benefits will not be affected as we work through this process. After the Rights & Responsibilities letter, claimants receive copies of all Conditional Payment Letters and any correspondence that the LRA has requested. You should keep these letters but you do not need to act on them. The LRA handles all lien correspondence.
I did not have insurance. Why do I have to wait for my money to be released?
As your attorney, we are legally and ethically obligated to verify and resolve certain types of healthcare liens. We are scanning health insurance databases to determine whether you are statutorily and/or contractually obligated to repay an insurer. When this process is complete and we confirm that you are not found in any database, money will be released to you.
What is a global healthcare lien resolution program?
As a claimant in this litigation, you have been enrolled in [INSERT GLOBAL PROGRAM]. In litigations with large numbers of claimants, it is common to proactively negotiate reimbursement terms with certain health insurers. This involves placing claimants with similar injuries into categories, determining an average cost of care for each category, and applying set lien reductions to each category. This practice ensures that claimants with similar injuries are treated similarly, and enables us to resolve liens as expeditiously and favorably as possible.
How long does it take to resolve healthcare liens and receive my settlement?
The time it takes to finalize healthcare liens depends on the type of lien involved. This process can take weeks to months. No matter the lien type, the steps in the traditional lien resolution process are the same:
- Reporting claimant information to the lienholder
- Receiving claims listings from the lienholder
- Auditing the claims and disputing any unrelated claims
- Negotiating and finalizing the lien
- Paying the lienholder from the settlement funds
Who is Rawlings/Equian/Optum/Hill HillCarter/Benefits Recovery/MSP Recovery?
These companies act as third-party administrators that specialize in recovering funds for health insurance companies by identifying situations where they should be reimbursed for medical costs paid out on behalf of a patient who has received a settlement from a third party responsible for their injuries.
What kinds of healthcare liens are common?
The following types of health insurers may have a right to be reimbursed from your personal injury settlement:
- Medicare Parts A & B: Medicare is a federal program that provides healthcare for persons age 65 and older, those qualifying for Social Security disability, and individuals diagnosed with end-stage renal disease or Lou Gehrig’s disease. When a Medicare beneficiary is injured and later receives compensation from the party that caused the injury, federal law enables Medicare to be reimbursed from those funds. In cases where Medicare is not reimbursed properly, Medicare may assert financial penalties against you. Accordingly, federal law requires you to satisfy any potential Medicare reimbursement obligation from your personal injury settlement proceeds.
- Medicare Parts C & D: Beneficiaries who qualify for Medicare coverage can receive their Medicare benefits through a private insurance company like Humana or UnitedHealthcare. This election is referred to as Medicare Part C and is more commonly known as a Medicare Advantage Plan. Medicare beneficiaries may also elect to purchase a Medicare Part D Prescription Drug Plan to cover medication that is not covered under Medicare Parts A and B. Both Medicare Parts C and D have the same rights of reimbursement described above for Medicare Parts A and B. Accordingly, you are required to satisfy any potential Medicare Parts C and D obligations from your personal injury settlement proceeds.
- Medicare Supplement Plans: Medicare supplement plans, commonly called Medigap plans, are insurance offered to Medicare beneficiaries to cover costs that Medicare Parts A and B will not otherwise cover. Unlike Medicare Parts A, B, C, and D, Medicare supplement plans derive their rights to reimbursement from state law instead of federal law. Nonetheless, many of these plans do have a right to be reimbursed from your personal injury settlement proceeds.
- Medicaid: Medicaid is a needs-based program available to people who are under certain income and/or asset thresholds, administered by the states with federal government oversight. The ability of these plans to seek reimbursement from injury-related settlements varies from state to state as the rules that guide each Medicaid program are unique to each state.
- Military Health Benefits: Members and retirees of the United States Military are able to receive healthcare benefits through a number of programs. The Department of Veterans Affairs (VA), for example, allows veterans who served during wartime to receive their healthcare free at VA hospitals and clinics. For active-duty members and their spouses and dependents, health insurance is commonly offered through the TRICARE program. Finally, CHAMPVA provides coverage to the spouse or widow(er) and to the children of a veteran who do not otherwise qualify for TRICARE. Federal law gives all of these military programs the ability to seek recovery directly from personal injury settlements.
- Workers Compensation: Workers Compensation (WC) benefits are given to employees who are injured as the result of a job-related function. In cases where you are receiving Workers Compensation benefits for the same injury that you are also receiving personal injury proceeds, Workers Compensation may have the right to recover from your personal injury proceeds. The laws governing Workers Compensation are unique to each state and the ability and amount that Workers Compensation can recover vary accordingly.
- Federal Employees: Individuals employed by the federal government are generally eligible for health benefits through a separate federal healthcare program. Under federal law, these plans have a right to seek recovery from your personal injury proceeds.
- Private Health Insurance: Many companies offer private healthcare coverage to their employees. Similarly, any individual can purchase a private health insurance policy. In some instances, varying from state to state and the specific plan, the private health insurance company may have a right to seek recovery from your personal injury proceeds.
