Healthcare Lien Resolution

GRG has received national recognition for our innovations in single event and mass tort case management. We pioneered the lien resolution process nearly a decade ago and continue to innovate as new legislation is enacted.

Each year we verify and / or resolve more than 100,000 healthcare reimbursement claims and liens. We bring tremendous efficiency and scale to healthcare lien resolution. Simply put, we know the most efficient process because we created it.

Repercussions of the Medicare, Medicaid, and  SCHIP Extension Act of 2007 (MMSEA)

Attorneys’ need for a trusted healthcare lien resolution service partner is more apparent now than ever before. Section 111 of the Medicare, Medicaid and SCHIP Extension Act (MMSEA) was enacted in 2009 and took effect in 2010, significantly changing resolution obligations. Under the MMSEA, the defense (or responsible party) must report certain information about settlements involving Medicare beneficiaries to Medicare. When it comes to Medicare reporting, the key to avoiding major disruptions in your cases is to start early and start right.

Obligations as Counsel

Failing to address Medicare, Medicaid, private health / ERISA and other healthcare lien obligations could adversely affect the claimant. He or she could lose eligibility for government assistance or healthcare coverage, or become the subject of a lien recovery action. Increasingly, federal and state statutes and the ABA Model Rules are making it plaintiff counsel’s obligation to identify the reimbursement obligations.

Each case demands a true strategy.

Attorneys must evaluate the following in each case:
  • Does the health plan have a reimbursement interest for past as well as future injury-related care?
  • Given the nature of the claimant’s recovery, is full reimbursement appropriate?
  • What are my obligations as an attorney in this settlement?
  • Am I liable?
  • What defenses, compromises, waivers or offsets are available?

GRG Solution to Lien Resolution

In each case, GRG will:
  • Determine the settling parties’ affirmative obligation to notify healthcare plans
  • Assess the healthcare plans’ right of recovery
  • Audit and analyze all reimbursement claims to determine accuracy and to “carve out” items unrelated to injury/settlement
  • Pursue relevant administrative remedies, such as damage allocation, waiver, and compromises to ensure the appropriate “net” recovery for the claimant
  • Handle other healthcare issues related to settlement. We also offer Medicare Set Aside (MSA) and MSA Custodial Account Services.

Single Event Healthcare Lien Resolution

GRG handles healthcare lien obligations in single event cases for thousands of firms across the country. We offer two unique solutions:
  • Compliance ProgramComprehensive, integrated, firm-wide solution to systematically address past and future cost of care obligations in every case and allow your firm to take advantage of preferred pricing and payment terms
  • Case Referral Program: Case-by-case evaluation and resolution of healthcare obligations

Mass Tort Healthcare Lien Resolution

GRG handles healthcare lien obligations in mass tort and class action matters with tremendous efficiency and scale. We have the resources to handle the biggest settlements, as well as the compassion, skill and discretion to handle the most delicate and sensitive cases.