PRACTICE AREAS
LEGAL SERVICES
De Leon Law. P.L.L.C., is dedicated to providing top-of-the-line legal service in the nuanced areas of subrogation and/or reimbursement in personal injury and workers' compensation matters. Below, please the services our firm is pleased to provide.
ERISA Subrogation
Subrogation and reimbursement claims under ERISA have been one of the most troubling issues facing personal injury and workers' compensation attorneys over the past thirty years. These liens are often availed of federal preemptive status, which allows entities pursuing these claims to circumvent state law consumer protections.
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De Leon Law, P.L.L.C., understands the ins and outs of these lienholders, how they operate, and what can be done to maximize the dollars going into the pocket of the truly deserving individual, the injury victim.
ERISA Plan Review
Often, understanding the legal scheme that may govern any particular health plan is not an easy task. It takes extensive experience to be able understand which plans may, or may not, be governed by the ERISA statute, how an ERISA-governed plan may be funded, and what legal arguments can be made against the sufficiency of the plan language contained in the operative plan documentation.
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De Leon Law, P.L.L.C., is a firm that has the experience and ability to decipher the confusing puzzle above. Our firm can provide a review and analysis of a health plan, its documentation, and its funding arrangement so as to ensure plaintiff counsel is well-prepared when that ERISA plan's recovery vendor comes knocking on the door looking for payment.
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FEHBA Subrogation
For years, reimbursement claims being pursued under the FEHBA statute have plagued federal employees that find themselves injured at the hands of an allegedly at-fault third party.
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As is the case with health plans governed by ERISA, FEHBA plans are also availed of federal preemptive authorities, which makes such lienholders' ability to pursue reimbursement claims against the proceeds of an injury victim that much more powerful.
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While FEHBA plans often possess a strong argument for reimbursement, their positions are not invincible. De Leon Law,P.L.L.C., will open every door and round every corner to ensure no argument, or dollar, is left behind.
Medicare Advantage Liens
In the modern day, Medicare Part C plans, or otherwise known as "Medicare Advantage Plans" are apprised of the same authorities as traditional Medicare A/B under the Medicare Secondary Payer Act (the "MSP Act").
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These plans will use the power of 42 U.S.C. § 1395y(b)(2) to pursue recovery of conditional payments made on an injury-victim's behalf, but they will try to circumvent the consumer protections placed in the MSP Act which may limit or reduce such health plans' recovery rights.
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De Leon Law, P.L.LC., understands the rules Medicare Advantage Plans are required to play by and will ensure that such rules are followed in order to protect the settlement dollars of the deserving injury-victims.
Private, State, and Local Liens
While certain statutory schemes such as ERISA, FEHBA, Medicare, and Medicaid often catch the headlines, it is important to remember that every state in the nation has various and sophisticated legal schemes, insurance codes, and case law developments that govern insurers and/or health plans' ability to pursue subrogation and/or reimbursement claims.
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Understanding the intricacies of these schemes, the recovery vendors that are pursuing reimbursement under these schemes, and the legal protections that can be invoked to shield the funds belonging to injury-victims from these schemes is something De Leon Law, P.L.LC., has developed over years of dealing with the insurance industry and its collection agents. Our firm will ensure that no law is circumvented which may be used to protect the funds of an injury-vicim.