For attorneys resolving bodily injury claims, securing a settlement, judgment or award is only half the battle. The next—and sometimes more challenging—step is resolving healthcare liens. These liens, which give lienholders the right to be reimbursed for medical expenses paid on behalf of an injured party, arise within a maze of laws, regulations and administrative hurdles.
Why Lien Resolution Is So Complex
Healthcare lien resolution isn’t simply a matter of cutting a check. It requires a deep understanding of the various types of liens—Medicare, Medicaid, ERISA, FEHBA, VA, TRICARE, private health insurance, and provider liens—each governed by different statutes, regulations and enforcement mechanisms. For example:
Medicare demands strict compliance with the Medicare Secondary Payer Act. Failure to report and reimburse properly can trigger double damages, interest, and even exposure for attorneys.
Medicaid lien rights vary dramatically by state, and attorneys must balance state-specific recovery rules against federal limitations set by cases like Gallardo, Ahlborn and Wos.
ERISA and self-funded employer health plans are governed by federal law but often hinge on plan language that must be carefully analyzed.
Military liens carry their own procedural rules and deadlines under the federal Medical Care Recovery Act that can stall a case.
Adding to the complexity, lienholders often overstate their claim, fail to account for procurement cost reductions, or include unrelated charges. Each lien type has different rules for disputing charges, negotiating reductions, and obtaining final satisfaction letters—processes that can stretch on for months.
The Time Drain on Attorneys
While attorneys focus on proving liability, calculating damages, and negotiating settlements, lien resolution runs on its own track—one with deadlines, forms, and agencies that do not move at trial speed. Delays from lienholders can jeopardize disbursement of funds, frustrate clients, and tie up law firm resources.
Moreover, each lien may require:
- Detailed review of medical billing records.
- Correspondence with multiple agencies/contractors.
- Negotiation over reductions, offsets or unrelated charges.
- Compliance with reporting obligations to avoid penalties.
Even experienced litigators find that lien resolution can consume disproportionate amounts of time, particularly when they are juggling active casework. In high-volume practices or multi-claim scenarios, lien management can become a bottleneck that delays closure and payment. For these reasons, more firms every year choose to outsource lien resolution to a law firm whose practice focuses on the subject.
Key Considerations for Outsourcing Lien Resolution
For law firms weighing the decision to outsource lien resolution, these are some of the primary factors to consider:
- Deep Knowledge of Multiple Lien Types. The lien resolution lawyers should understand the nuances of every major lien category, including federal, state, and private claims, allowing them to anticipate issues before they become obstacles.
- Aggressive but Compliant Negotiation. Leveraging statutory rights, case law and equitable arguments, the lien resolution lawyers should regularly negotiate significant lien reductions—helping maximize clients’ net recoveries while keeping attorneys in compliance.
- Efficient Processes and Relationships. The lien resolution lawyers should have years of experience working with lienholders, allowing matters to move forward efficiently.
- Freeing Attorneys to Focus on Advocacy. With lien resolution in capable hands of the lien resolution lawyers, attorneys should be able to concentrate on case strategy, trial preparation and client counseling—secure in the knowledge that the financial backend of the case is being handled with professionalism and attention to detail.
A Strategic Partnership Yielding Better Outcomes
In today’s legal environment, where settlements are closely scrutinized and lienholders are increasingly aggressive, healthcare lien resolution is too important to be an afterthought. The reality is that resolving liens isn’t just a clerical task—it’s a specialized legal process with real financial and compliance stakes. By bringing in lien resolution lawyers who do this work every day, attorneys can protect themselves, serve their clients more effectively, and get to the finish line faster.
