Mass Tort Lien Resolution Administration

Is Its Own Specialized Discipline

Lien resolution sits at the intersection of federal reimbursement law, state lien statutes, and individual plan terms, and it has to be handled correctly for every single claimant before any settlement fund can be safely disbursed. A firm that disburses settlement proceeds without properly resolving a Medicare lien, for example, exposes itself and its client to direct federal recovery action, including double-damages exposure under the Medicare Secondary Payer statute. The stakes of getting this phase wrong are statutory.

At mass tort scale, lien resolution multiplies in complexity. A claimant population of a few thousand people will include a wide mix of lien types and lienholders, each with its own resolution process, negotiation posture, and timeline. Medicare conditional payment amounts must be requested, reviewed for accuracy, and often disputed or negotiated down. Private insurers and ERISA plans operate under different reimbursement rules entirely, frequently requiring direct negotiation rather than a standardized administrative process. Managing this volume and variety without dedicated infrastructure creates exactly the kind of bottleneck that stalls an otherwise-finished settlement program for months.

1

Medicare & Medicare Advantage Lien Resolution

We manage the Medicare Secondary Payer recovery process from initial reporting through final resolution:

• Section 111 reporting coordination to confirm claimant Medicare status is properly identified at settlement
• Conditional payment letter requests and review for accuracy against the claimant's actual treatment related to the underlying injury
• Disputing unrelated charges included in a conditional payment letter, with supporting medical documentation
• Final demand resolution and negotiation, including coordination through the Medicare appeals process where necessary
• Medicare Advantage plan lien identification and resolution, handled separately from traditional Medicare given differing recovery procedures
  

2

Medicaid Lien Resolution

Medicaid liens are governed by state-specific statutes and recovery procedures, and we manage resolution according to the rules of the relevant state Medicaid program, including negotiating reductions consistent with applicable state and federal case law governing Medicaid reimbursement caps.

3

ERISA & Private Health Plan Lien Negotiation

Self-funded ERISA plans and private insurers often assert reimbursement rights under plan language rather than statute, which means resolution typically requires direct negotiation rather than a standardized administrative process.

• Plan document review to confirm the actual scope and validity of the asserted reimbursement right
• Negotiation of lien reduction based on equitable defenses, made-whole doctrine arguments, and common fund principles where applicable under the relevant jurisdiction
• Tracking of negotiated resolutions and final payoff amounts across the claimant population

4

Hospital & Provider Lien Verification

Hospital liens are governed by state lien statutes that vary significantly in scope and required procedure. We verify every asserted hospital or provider lien against the controlling statute and negotiate reductions where the law and facts support one.

5. Centralized Lien Tracking Across the Claimant Population

Where Payout

Lien resolution is a precondition to payout and distribution administration, not a parallel process. No claimant file should move to final disbursement calculation until every applicable lien is resolved or a properly documented holdback is in place. Treating lien resolution as a gating step, rather than something handled reactively after a claimant complains about delay, is what keeps an entire settlement program moving on schedule.