- November 13th, 2013
There is some important news out of Albany: yesterday Governor Cuomo signed a bill (S5715A; A7828) amending the New York anti-subrogation law (General Obligations Law § 5-335). The new law, sponsored by NYS Assemblywoman Helene Weinstein (A.7828) and State Senator John Bonacic (S.5715),is aimed to eliminate the holding of the case of Wurtz v. Rawlings Co., LLC, 2013 WL1248631 (E.D.N.Y. 2013), which held that §5-335 was preempted as it applies to insured employee benefit plans under ERISA.The legislative intent from the bill is quite clear:
The instant legislation is intended to make clear the original purpose of sections 5-101 and 5-335 of the general obligations law which is to ensure that insurers will not be able to claim or access any monies paid in settlement of a tort claim whether by way of a lien, a reimbursement claim, subrogation, or other- wise so that the burden of payment for health care services, disability payments, lost wage payments or any other benefits for the victims of torts will be borne by the insurer and not any party to a settlement of such a victim's tort claim.
- June 7th, 2013
Changes are forthcoming in the law for Medicare Set-Asides (MSAs) in liability cases. Just what those changes are have not been determined as of yet.
Recently, Advanced Notice of Proposed Rulemaking has been promulgated by CMS for public comment. There are seven (7) proposed options as to how Medicare beneficiaries and their attorneys can meet their obligations to protect Medicare's interest when future medical care is claimed or the settlement, judgment, award, or other payment releases (or has the effect of releasing) claims for future medical care.
Options "1" through "4" apply to both Medicare beneficiaries and those with the "reasonable expectation" of becoming a Medicare beneficiary. Options "5" through "7" apply only to Medicare beneficiaries.
- January 3rd, 2013
In a reversal of arguments as to the enforceability of claims for reimbursement of Medicare Advantage Plans, on December 26, 2012 [argued September 21, 2012] the New York State Appellate Division, Second Judicial Department has reversed the lower court's decision in the appeal of the matter of the Kings County Supreme Court decision of Trezza v. Trezza, 32 Misc 3d 1209[A], 2011 NY Slip Op 51237[U] (Sup Ct, Kings County).
The Second Department held that: "General Obligations Law §5-335, insofar as applied to Medicare Advantage organizations under Part C, is preempted by federal law since it would impermissibly constrain contractual reimbursement rights authorized under the "Organization as secondary payer" provisions of the Medicare Act."