Medicare Lien Personal Injury Settlement

If you achieve a settlement for a client in a personal injury case who received Medicare benefits, there’s an additional layer of work to be done. That client will be required to use settlement funds to repay Medicare for the money spent on injury care. Depending on the amount, Medicare liens in personal injury cases can garner the entire settlement. So it’s not as simple as giving Medicare their due. The assistance of a group who understands the process of working with Medicare can be greatly beneficial to your client. The experts at Synergy Settlement Services have the knowledge and resources necessary to achieve a positive outcome when dealing with Medicare liens involving personal injury settlements.

Dealing with Medicare Liens in Personal Injury Cases

Personal injury cases involving Medicare can be particularly difficult because of Medicare’s lengthy process and inflexibility when it comes to settlements. First, Medicare must be notified if your client has been injured and requires medical care. If your client files a claim, but doesn’t notify Medicare that they were involved in an accident, they will be subject to fines. After your client receives medical treatment, Medicare will send a conditional payment letter, which lists all medical procedures that they have paid for. We will review this letter and contest any procedures that are unrelated to the personal injury claim.

Medicare will not reduce the amount of a Medicare lien placed on a settlement agreement; however, there are a few circumstances in which we can pursue waivers for your client. This includes:

  • If the probability or the amount of a recovery doesn’t warrant the pursuit of a claim, a waiver or a compromise may be established, according to the Federal Claims Collection Act.
  • If a waiver is in the best interests of the Medicare program, according to the Secretary of Health and Human Services.
  • If the lien is against a person without fault and would either defeat the purposes of Social Security or Medicare or would be against “equity and good conscience.”

About Synergy

For more than a decade, Synergy has worked with attorneys and their clients to provide innovative lien resolution services. We have the experience, contacts in key agencies, and the myriad of resources necessary to help your clients keep as much of their settlement as possible. Working with Medicare is an arduous, but necessary process. Let us handle this on behalf of your clients so that you can focus on core tasks.

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.


"Coincidentally, on the day of a recent Synergy Seminar on Medicare & ERISA lien resolution I received a letter on an ERISA lien. This letter followed much back and forth between myself and the recovery vendor for BCBS. Despite my efforts they were adamant there would be no (zero)(zilch)(nada) reduction and provided case law to support their position. I tried Synergy’s Lien Resolution Services since I had just heard their Director of Lien Resolution speak. Synergy got them to reduce their claim by a third in less than ten (10) days. The result was quick and the fee very reasonable. If you have a tough ERISA lien and your typical efforts don’t work, give Synergy a try."

Michael S. Smith, Esq.
Lesser, Lesser, Landy & Smith, PLLC

"I just want to thank Synergy for their great work in getting a health insurance lien resolved. The health insurance company refused to reduce their lien a penny from a motorcycle accident involving my client who was not wearing a helmet, a fact that would have hurt our award in front of a jury. Synergy put tremendous pressure on this company, and after months of bombarding this insurance company with statutory requests and threats, they were able to get them to give in and reduce the lien significantly. The cost was minimal in relation to the hard work they put in, and the savings my client received. Client was very happy, and it allowed me to close out a case that I had resolved over 6 months before. Keep them in mind if you are dealing with a smug insurance adjuster who felt confident he would not have to reduce a lien, like I was dealing with. Thank you very much Synergy."

Jeffrey A. Adelman, Esq.
Adelman & Adelman, P.A.

WordPress Image Lightbox