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  • Melisa Zwilling

Why It's Important: Timely Resolution of Conditional Payment Claims


In Iowa Supreme Court Atty. Disciplinary Bd. v. Silich, No. 15-1227, 2015 Iowa Sup. LEXIS 97 (Iowa, December 4, 2015), a complaint was brought by the state disciplinary board against an Iowa plaintiff’s attorney, Paul Silich, after it took him thirty-three months to resolve the Medicare lien in his clients’ liability case.

Silich represented the conservator for the son of the deceased injured party as well as Clinton National Bank, the administrator of the injured party’s estate. In December 2011, the parties agreed to settle the case, conditioned upon the plaintiffs resolving any Medicare lien. While Silich did ultimately resolve the lien on his clients’ behalf, it was not until September 2014 that the lien was fully resolved. During this process, which exceeded two years, Silich failed to communicate with his clients for months at a time and also went months without following up with Medicare regarding the liens asserted. Silich’s failure to properly handle the Medicare conditional payment claim research resulted in unreasonable delays for his clients and additional costs associated with such delays.

After Silich failed to comply with the orders of the court to communicate with his clients regarding the Medicare liens, the court referred the matter to the state attorney disciplinary board. The Board found that Silich failed to properly communicate with his clients, expedite the litigation, and handle the case with the due diligence required of an attorney. The Iowa Supreme Court agreed with these findings and suspended Silich’s license to practice law for thirty days.

As this case illustrates, the efficient resolution of Medicare conditional payment claims requires regular follow ups with Medicare and consistent communication with clients. The Silich case serves as an example of the frustrations, delays, and added costs experienced when this does not occur. We strive to make the conditional payment claim research process as simple for our clients as possible by following up with Medicare regularly and notifying clients when we receive any information from Medicare regarding conditional payment claims in their case.

If you would like our assistance with conditional payment claim research in your case, please contact us and we will be happy to assist you.

#CarrAllisonMedicareCompliance #IowaSupremeCourt #MedicareConditionalPaymentClaim

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