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Lawyers need to know who has valid claims, and for what amount, before they can divide up the settlement funds in a personal-injury case. If Medicare covered the plaintiff’s costs of treatment, it typically has a lien for what it paid. But until a recent breakthrough, Connecticut lawyers report they have had a devil of a time obtaining Medicare lien figures. As a result, settlement funds have sometimes languished in lawyers’ trust accounts for years, awaiting the necessary information from government bureaucrats. The situation was getting so bad, some plaintiffs lawyers grew reluctant to take personal-injury cases for elderly Medicaid recipients, said Hartford, Conn., attorney John L. Bonee III. In the past, lawyers were instructed to fax their request for lien figures to Medicare officials in New York or Pennsylvania. They were provided with a fax number but no contact person. “You didn’t hear back, and you didn’t have anyone to speak with about it,” said Bonee of Hartford’s Bonee Law Offices. In August, at the suggestion of local judicial administrators, Bonee wrote a letter to Clarine Nardi-Riddle, chief of staff for Democratic U.S. Sen. Joseph I. Lieberman. An issue that “continues to vex personal injury attorneys and the judiciary” and delay settlements is the difficulty of ascertaining Medicare lien figures, Bonee wrote. “It is virtually impossible to get a prompt calculation of the amount of the Medicare lien from the federal government,” he said. Last month, Lieberman wrote Mark B. McClellan, who heads the Center for Medicare and Medicaid Services, looking for answers. Within a matter of days, Bonee received file numbers for two of his cases from CMS and instructions on how to contact Harrisburg, Pa.-based Empire Medical Services, the lead coordination of benefits contractor for his clients’ claims. Under federal regulations, Medicare calculates the amount of its lien through a formula that reflects attorney fees and costs. This usually reduces the lien owed to Medicare. A liability examiner, Kathy Cornelius, explained in an Oct. 10 letter to Bonee that, once a settlement is reached, Empire needs the settlement date, settlement amount, attorney fees and an itemized list of disbursements to make its calculations. Once the lien amount is calculated, Cornelius wrote, “you will then be notified of the amount owed to Medicare.” HUMAN CONTACT Cornelius also included a telephone number where custom service officials can be reached. “How wonderful!” Bonee exulted in an e-mail he sent to members of the Hartford County Bar medical-legal subcommittee Oct. 20. “When I called, I actually got a very polite and knowledgeable person with whom to communicate and get questions answered. Let’s hope this continues.” At the main Medicare Coordination of Benefits number in New York, (800) 999-1118, customer service representatives can identify the lead coordination of benefits contractor for a specific case and begin the process of assigning a case number. Service representative Ron Charles said lawyers should contact Medicare’s main office at the beginning of the settlement process, obtain a file number and begin the calculation process with their regional lead coordination of benefits contractor. Charles said Medicare changed to its current “lead contractor” system in 2001. “In the beginning, prior to 2001, some records were created incorrectly. Now, things are pretty much better,” he said. He recommended that attorneys contact Medicare from the beginning and start a case file with the proper lead coordination of benefits contractor for their region. If lawyers wait until the settlement is nearly complete to start the lien calculation process, delays will result, he cautioned.

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