Resolving Health Care Liens in Mass Tort Lawsuits: The Private Lien Resolution Program

Lien resolution is a dreaded part of personal injury law practice. However, proper resolution of lien obligations is critical to securing your clients’ rights and protecting them from adverse financial damages. In the world of mass torts, the Private Lien Resolution Program (PLRP) was created precisely to make meeting lien resolution obligations less painful for attorneys and their clients.

Subrogation liens frustrate both lawyers and clients.

Clients are understandably upset when they learn about all the business entities that can skim money off the top of their personal injury settlements. While we can warn them of discretionary items like cash advances, we have practically no control over the subrogation liens health insurance providers claim.

As attorneys, explaining subrogation liens to clients is a critical part of our work. Failure to handle these liens properly can delay settlements. Even more important, not fulfilling lien obligations can cause your clients to become ineligible for health insurance or expose them to financial penalties.

The PLRP is unique to mass tort litigation and simplifies the highly detailed and specialized work required to ferret out subrogation claims. This voluntary program was established to resolve health care liens asserted by private health insurance providers against claimants in mass tort settlements.

PLRP programs apply to specific types of liens:

· private health insurance plans;

· some Medicare Part C private insurance plans; and

· some ERISA plans.

In car accident and truck accident cases, and similar one-off lawsuits, you typically deal with one client’s health insurance providers. In mass tort litigation, however, there are hundreds – even thousands – of clients involved in settlements. The specialized skills of a lien resolution firm, such as Epiq Global, can make determining final lien outcomes seamless.

PLRP basics

The PLRP is designed to deliver some of the efficiencies that fueled the development of MDLs in the first place. The PLRP applicable to any mass tort settlement is negotiated by the settlement committee. Generally, the plaintiff firms must pay the cost of lien resolution – finding out what liens exist, their value, and what compromise can be negotiated. Lien resolution can easily cost clients hundreds or thousands of dollars in expenses on top of the deductions for the liens themselves.

Sometimes plaintiffs’ settlement committees are able to get defendants to foot the bill for lien resolution. This can be a real boost when per-client settlements are underwhelming due to the paucity of defendants’ gross settlement fund and the number of claims against it.

Once clients opt into the program, the PLRP specialist does all the footwork. Clients provide basic information about their health insurance providers and account numbers, then the PLRP firm provides the following services:

· acquiring the billing records;

· checking records to make sure charges apply to the injury at issue;

· negotiating with the insurance company to get the lowest possible payback; and

· finalizing the lien and reporting each client’s balance to their law firm for deduction.

PLRPs provide expertise and efficiency

The law surrounding health insurance liens is complicated. For example, Medicare may have a first right of recovery in certain situations. The liens to which private insurers are entitled depend on the specifics of their contract with your client (in the reimbursement sections outlining subrogation rights). Federal and state law can also play a role. It helps to have a company with expertise in navigating all these complexities working for your clients.

Also, PLRPs provide efficiencies in costs and resource use, just as MDLs do. For example, because of the large numbers of claimants, insurance companies participating in the PLRP generally agree to a cap on the percentage of a settlement that can be used to satisfy lien obligations.

Private Lien Resolution Programs save law firms countless hours by doing the work of combing through the bills insurers provide to make sure that charges only apply to the injury that is the subject of the litigation.

Lien resolution experts

The firm that provides lien resolution in a mass tort is part of the negotiated settlement agreement. The two primary providers in the U.S. are:

• Archer Systems; and
• Epiq Global, a Founding Member of The Mass Tort Institute.

When your firm uses a health care lien resolution specialist, your staff is spared the time- and resource-heavy burden of determining obligations to pay health care insurers. That leaves you free to focus on your core goal of advocating for your client.

At The Mass Tort Institute, our mission is to raise the level of knowledge, skills, and resource sharing among mass tort industry professionals.

About the Author

Donna is a social justice warrior and storyteller. With a Master of Public Affairs degree from the LBJ School of Public Affairs and a J.D. from The University of Texas School of Law, she has represented the downtrodden throughout her career.

Donna serves on the board of Women on the Border, a non-profit dedicated to publicizing stories of marginalized workers in the global economy and immigrants victimized by hostile anti-immigration policies. She was President of the Texas Women’s Political Caucus during the 2018 watershed elections and helped successfully place women in political offices at the national, state, county, and local levels.

Having witnessed the extent to which corporate actors will abuse consumers, Donna could easily let the scoundrels get her down. Instead, Donna views life’s obstacles as fodder for good stories – stories to inspire societal growth.