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Torts – Effect of The Howell Decision on Liens Brought Under The Hospital Lien Act

Dameron Hospital Association v. AAA Northern California, Nevada, and Utah Insurance Exchange et al. - California Court Of Appeal, Third Appellate District (September 4, 2014) - In Howell v. Hamilton Meats (...more

Insurers, Be Ready To Pay Twice In Texas

Often, an insurance carrier will issue a check to two joint payees — the named insured and either a public adjuster or a mortgagee. What happens when the one payee cashes the check without first obtaining a signature from the...more

Understanding the Relationship Between Medicare and Medicaid Liens and Litigation

Behind many personal injury and professional malpractice cases lurks a nagging reality that will almost always impact settlement negotiations – a Medicare or Medicaid lien. In general, a lien is a security interest granted...more

Florida Supreme Court Strikes Down Wrongful Death Non-Economic Damages Cap for Med Mal Cases

On March 13, 2014, the Florida Supreme Court, in a 5-2 ruling, issued its long-awaited opinion following review of the Eleventh Circuit Court of Appeal’s decision in Estate of McCall v. United States, 642 F.3d 944 (11th Cir....more

Medicare Change Means Those with Small Personal Injury Claims Can Settle Cases Quickly

Beginning on October 1, 2014, Medicare will no longer attempt to obtain reimbursement from personal injury plaintiffs with claims worth less than $1,000, and those beneficiaries will no longer have to give Medicare notice of...more

ERISA (7th Cir.): Beneficiary and Attorney Who Ignore Subrogation Lien for Medical Bills Paid by ERISA Plan “Better Call Saul”

You have seen this one before: The ERISA plan pays hundreds of thousands of dollars in medical bills and secures an equitable lien. Then, the ERISA plan beneficiary settles a tort claim, but refuses to reimburse the ERISA...more

Florida Supreme Court Holds Statutory Cap on Non-Economic Wrongful Death Damages in Medical Malpractice Actions Violates the...

In Estate of Michelle Evette McCall, et. al. v. United States of America, SC11-1148 (Fla. 2014), the Florida Supreme Court decided the following certified question: Does The Statutory Cap On Wrongful Death Noneconomic...more

Limitations in Medical Payments (LIMP) (HB 379/SB 1128)

Limitations in Medical Payments (LIMP) bills have been filed in both chambers of Florida Legislature (HB 379 by Rep. Hood and SB 1128 by Sen. Richter). The reconciled bill, if passed, would allow a jury rather than medical...more

Affordable Care Act Has Potential to Limit a Defendant’s Exposure for Future Medical Costs in New York Personal Injury Litigation

Generally overlooked in the national debate surrounding the Patient Protection and Affordable Care Act (ACA) is the effect the new law will have on personal injury litigation. If standard loss-allocation and mitigation rules...more

The Supreme Court Defers to Plan Language in U.S. Airways, Inc. v. McCutchen

Summary - In U.S. Airways, Inc. v. McCutchen, the US Supreme Court recently considered whether certain equitable defenses override the terms of a welfare plan in a plan fiduciary's suit for reimbursement under §...more

Private Health Care Providers Should Understand the Risks When Treating Inmates - BB&K's Jared Goldman Examines the Potential...

If you have worked in correctional health care for a while, you have heard about the Eighth Amendment’s prohibition against “deliberate indifference” to an inmate’s medical needs. But you may be unaware of the patchwork of...more

Florida Legislature Allows Plaintiffs to Contest Their Reimbursement to Medicaid

Effective July 1, 2013, Florida’s Medicaid Third-Party Liability Act now provides a mechanism for recipients of Medicaid to challenge the amount they must reimburse Florida’s Agency for Healthcare Administration (AHCA) after...more

Florida Medicaid Liens After Wos

The 2013 Florida legislature wasted no time responding to the March 20 Supreme Court opinion in Wos v. E.M.A., 568 U.S. __ (2013)....more

A prerequisite to the recovery of fees: How "reasonable and necessary" are your charges?

In State Farm Mutual Automobile Insurance Co. v. Huff, 2013 DJDAR 7379 (2013), the California Court of Appeal for the Fourth Appellate District decided a novel fee case in the medical context, referencing standards used to...more

Express Plan Terms Allow Self-Insured Plan to Recover Medical Benefits Paid to Employee Post-McCutchen

In Quest Diagnostics v. Bomani, et al., 11-CV-00951 (D. Conn., June 19, 2013), the court granted Quest Diagnostic’s (“Quest”) motion for summary judgment, ruling that Quest, as the fiduciary to its self-insured medical plan,...more

Are Medicare Set-Asides Required During the Settlement of Personal Injury Claims?

There has been a lot of talk amongst the plaintiff’s bar relating to Medicare Set-Asides (MSA*) and whether they are required when we recover money for a Medicare-eligible client. As one who takes a particular interest in...more

Group Health Plan Can Enforce Reimbursement Rights Against Trustee

On the heels of the United States Supreme Court’s recent holding in U.S. Airways v. McCutchen, where the Court held that a group health plan’s reimbursement rights are not automatically subject to equitable defenses, it...more

High Court Holds Equitable Defenses Do Not Trump ERISA Plan’s Clear Reimbursement Language

The Supreme Court’s April decision in U.S. Airways, Inc. v. McCutchen resolves a circuit split on the issue of a medical plan’s right to reimbursement of medical expenses from a plan participant who recovers on a personal...more

California Appellate Courts Impose Significant Limitations on Plaintiffs’ Claims for Medical Damages

In two recent opinions, the California Court of Appeal has clarified and expanded the scope of the California Supreme Court’s holding in Howell v. Hamilton Meats and Provisions, Inc., 52 Cal.4th 541 (2011), regarding the...more

Court of Appeal Applies Howell Rule to Future Medical Expenses and Noneconomic Damages

In Howell v. Hamilton Meats & Provisions, Inc., the California Supreme Court ruled that where a plaintiff’s medical care provider, pursuant to a prior agreement with the plaintiff’s health care provider, accepted less than...more

Cross-Border Crashes: How Canadian Healthcare Can Affect Your Settlement

Despite the efforts to prevent accidents, crashes with Canadian drivers are still an all too common occurrence in Washington State. To make matters worse, dealing with Canadian insurance companies can be confusing and...more

California Appellate Court Confirms Cap on Past Medical Expenses Applies to Medicare Payments and Should Be Imposed before Further...

In Luttrell v. Island Pacific Supermarkets, Inc. (April 8, 2013, A134089), California’s First District Court of Appeal held that Howell v. Hamilton Meats & Provisions, Inc. (2011) 52 Cal.4th 541 specifically applies to limit...more

Supreme Court Clarifies Subrogation Rights, Emphasizes Need for Precise Plan Language

Plan sponsors, particularly those that sponsor self-funded health plans, should review plan document provisions in light of the recent decision of the Supreme Court of the United States in US Airways, Inc. v. McCutchen. In...more

Supreme Court Upholds Health Plan’s Right To Recover Money from Third Party

The U.S. Supreme Court has ruled that the clear terms of an employer's group health plan override an employee's equitable defenses in determining the plan's right to recover amounts from a third party. This decision points...more

The U.S. Supreme Court Upholds Plan Sponsor’s Recovery Of Participant Damages Award

On April 16, 2013, the U.S. Supreme Court issued its opinion in U.S. Airways, Inc. v. McCutchen finding in favor of U.S. Airways in its quest to recover $66,866 in medical expenses incurred by its employee as a result of a...more

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