Resolving Medicare Liens

Resolving Medicare Liens in Personal Injury

If you are an attorney working on a personal injury case hoping to obtain that crafty Medicare lien resolution then you already know that this is among the more frustrating legal experiences you can participate in. Perhaps the only thing more frustrating is that Medicare will delay your client’s settlement check at the end of the case if the final demand has not been reached.

Taking the following logical steps and putting them into action can guide you in the right direction regarding obtaining that lien resolution for your client.

Gather Resources and Set Expectations

When first meeting your client, make sure you learn as much as you can about their Medicare situation including if they receive benefits or communicate with Medicare. After speaking with them, make copies of any of these relevant items. Keep in mind that clients are typically impatient when it comes to wanting their settlement money. It’s important that you set their expectations low and inform them that Medicare moves at a snail-like pace and that it will be a long process to get to the finish line.

Notify Medicare A.S.A.P. and Act Accordingly

The quicker you provide the three major pieces of relevant information (beneficiary, case, and representative) to Medicare the less painful the process is. Eventually, the Medicare Secondary Payer Recovery Center (MSPRC) will send you the Rights and Responsibilities letter which will be your guideline through the settlement process. Submit your Proof of Representation to MSPRC and they should issue a Conditional Payment Letter within 65 days. This letter should include all the finances Medicare includes for your case. However, you will need to closely examine it as it will likely have some unrelated medical listings not related to your case.

Settle the Case

After reviewing the conditional payment letter and monitoring the case, you will eventually reach your settlement and need to contact MSPRC to divulge the relevant settlement info including: settlement amount, attorney’s fees, liability insurer information, and a copy of the settlement agreement. This information will determine Medicare’s final demand amount. After eventually receiving the demand, pay Medicare their amount owed and determine whether or not to appeal the final demand if necessary.

Obtaining a Medicare lien resolution can be a long and arduous process. If you cooperate with Medicare by quickly submitting all relevant documents and communicate well with your client, you should at least reduce some of the hassles of a lien resolution.

For more information or to schedule a consultation, please submit our contact request form or call (877) 242-0022.

Disclaimer: The information contained in this article is for general educational information only. This information does not constitute legal advice, is not intended to constitute legal advice, nor should it be relied upon as legal advice for your specific factual pattern or situation.


"I recently engaged Synergy to assist with a complicated PTD settlement involving a substantial Medicare Set Aside. The claimant’s wife has been providing full time attendant care which is not Medicare covered. The Synergy nurse was able to do a full analysis of non-Medicare covered expenses which far exceeded the value of the MSA analysis performed by the carrier’s contracted MSA provider. The non- Medicare figures became the main focus of the settlement negotiations and more than doubled the value of the case. Although I could estimate the attendant care figures, the nurse added in other items that I would not have routinely considered. I also asked Synergy to evaluate the EC’s MSA as well as their prescription review. Synergy offered insight about the prescription donut hole which I did not have a clear understanding about. Again, their insight and information added a great deal of value to the overall settlement. Not only did I learn from Synergy but was able to educate my clients in the process. These are very complex and complicated areas; I will use Synergy again and again!"

Rosemary Eure
Lancaster & Eure

"We have been using the lien resolution services Synergy offers for over a year, and it has been a load off of our back. As a trial attorney, I need my staff to spend time on litigation, not waste their time on hold with Medicare. The time and effort that we used to spend resolving issues with Medicare is now being used in much more productive ways. I haven’t called Medicare in over a year, and I hope I don’t have to call them again."

John D. Ayers, Esq.
Marks & Harrison, P.C.

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