Medicare Settlement Consultation
Your resource for resolving Medicare Secondary Payer issues.
Daniel Hayes founded Hayes Firm, PLLC, to provide clients a dedicated resource focused on resolving Medicare Secondary Payer issues. This law firm is distinguished based on Daniel’s years of experience handling and defending workers’ compensation insurance claims. Informed by that experience, Medicare issues are approached with common sense, creativity, and a goal of preserving the client’s money. A primary objective is to be responsive and accessible in each assignment, avoiding a one-size-fits-all model. Clients stay advised every step of the process. You can expect quick turnaround on assignments, while staying updated on policies and developments from the Centers for Medicare & Medicaid Services and the courts.
Contact
Post Office Box 7346
Asheville, North Carolina 28802
daniel@hayesfirmpllc.com
(919) 805-4385
Areas of Practice
Medicare Set-Asides
Preparation of Medicare Set-Aside proposals for workers’ compensation and liability settlements. For settlements that meet the workload review thresholds, voluntary submissions may be made to the Centers for Medicare & Medicaid Services (CMS) for formal review. For settlements that do not qualify for voluntary submission to CMS, the MSA may be relied upon by the parties to the settlement.
Legal Opinion Letters
Legal consultation in cases where a formal MSA allocation may not be necessary or appropriate, including workers’ compensation and liability “compromise” settlements with denied liability, as well as settlements where a zero-dollar set-aside may be indicated. Clients are provided a comprehensive analysis of the potential Medicare Secondary Payer issues, current “best practices” and recommendations for risk management, and documentation of the steps taken by the party/parties to adequately consider Medicare’s interests.
Medicare Conditional Payments
Verification and resolution of Medicare conditional payments pending with the Centers for Medicare & Medicaid Services (CMS). Any settlement involving a Medicare beneficiary—whether liability or workers’ compensation—may have a potential conditional payment issue.
Verification of a claimant/plaintiff’s Medicare beneficiary status. Establishment of Medicare conditional payment claim. Appeal of Medicare liens, including requests for removal of unrelated charges, as well as challenges based upon waiver or partial waiver for financial hardship, waiver or partial waiver for equity and good conscience, and request for compromise in the best interests of the Agency.
“There can be no doubt but that the statutes and provisions in question, involving the financing of Medicare and Medicaid, are among the most completely impenetrable texts within human experience.”
– Rehabilitation Ass’n of Va. v. Kozlowski, 42 F.3d 1444, 1450 (4th Cir. 1994).
About the Firm
Hayes Firm, PLLC, a single-member law office located in Asheville, North Carolina, is AV Peer Rated by Martindale-Hubbell for the Highest Level of Professional Excellence.