ROUNDUP UPDATE – September 29, 2022
CMS (Medicare) notified ARCHER and other Lien Resolution Administrators on September 21st that it is now declining reimbursement of any Medicare liens through the previously established global resolution model for anything less than the full lien amount due, which for many claimants is equal to the entirety of their net settlement award (previously, Medicare allowed “compromises” to lien amounts and capped their reimbursement at no more than 30% of a claimant’s net settlement). The result of Medicare’s decision, two years after ARCHER began its work with the Roundup Medicare Model, requires ARCHER to pause global model Medicare lien resolution across all pending Roundup cases. ARCHER and other Lien Resolution Administrators are working together to challenge Medicare’s decision and further information will be provided as it becomes available.
As a result of Medicare’s actions, we expect further delays in processing any second payments that may be due.
ROUNDUP UPDATE – JULY 1, 2022
We are continuing to work hard to conclude your Roundup case. Below are answers to FAQS:
When will I receive my second payment?
The Lien Administrator (Archer) is in the process of determining how much (if any) of the money held back from your first payment is required under Federal Law to be paid back to Medicare/Medicaid. If you signed up for the Private Lien Resolution Program, Archer is also working on determining how much will need to be paid to your private insurer. This process has taken longer than initially anticipated and Archer is still waiting on Medicare/Medicaid to provide final confirmation on payment amounts. Archer has told us that it will have this process complete in September. If this occurs on time then we will be able to make you second payment (if applicable) in October. For more details on the lien resolution process, see the ARCHER FAQ below.
We cannot release lien holdback money until Archer finalizes your lien. This is true even if you disagree that a lien was properly asserted.
The Settlement Administrator has set the final point value at $395.00 which is the exact estimate that your initial payment was based on. Any second payment will, therefore, consist of the difference between your lien holdback and the final lien amount. Please note that not every claimant will receive a second payment.
If your second check in less than $35,000, it will be mailed to you. If it is $35,000 or more you will receive an email with instructions on how to receive your payment.
When will I know if I qualify and if so how much I will receive for my Extraordinary Injury Fund (EIF) Application?
The Settlement Administrator and Special Master are currently reviewing EIF Applications and making eligibility determinations. We expect, but cannot guarantee, that notifications and payments for those who qualified by the end of the year.
When will I receive my first check for the claim I have made on behalf of a deceased Roundup User?
If you have not yet received your first check and are not actively working with an attorney on this, please contact your assigned attorney at The Miller Firm.
I have a Bankruptcy Hold on my payment. What do I do now?
Our attorneys are actively working with your Bankruptcy Trustee to resolve this issue. If you were diagnosed with NHL before you filed Bankruptcy, the Bankruptcy Trustee may be entitled to part or all of your settlement under applicable Bankruptcy law. We will let you know when/if you are entitled to a payment and if so how much.
LIEN ADMINISTRATOR (ARCHER) FAQ
I didn’t hire ARCHER. Why are they involved?
In order to comply with the terms of the settlement agreement and with federal law, which require assurance that government liens are properly satisfied, the Master Settlement Agreement appointed ARCHER to serve as the Lien Administrator. ARHER was selected for its expertise and experience in handling specialized administrative functions, including health insurance lien resolution which is required in large mass tort settlement programs such as Roundup. ARCHER also has negotiated special programs with government lienholders and private group health plan collectors. These programs offer advantages such as caps on lien recoveries and automatic, built-in lien reductions that are not offered to individual claimants or law firms on their own.
Why has this taken so long?
Mass tort lien resolution is very complex. There are many different government agencies and hundreds of health plans that are all looking to assert their lien rights or subrogation claims against Roundup settlement proceeds. Compounding the complexity is the fact that Medicare, Medicaid agencies, private insurers/their recovery agents, and other government agencies such as the VA are facing an unprecedented volume of mass tort claims and continue to deal with staffing issues and resource shortages, which is lengthening the time it takes to resolve liens.
ARCHER’s job is difficult, as Congress has placed Medicare, Medicaid, other government agencies, and certain health plans in a favored position to recover money when beneficiaries reach a third-party injury settlement. ARCHER has negotiated what it felt to be the best possible agreements with the government and the vast majority of health plans, agreements that have been approved by the leadership law firms in the Roundup litigation nationwide.
Why did I have to go through the lien resolution process?
Federal law requires that all Medicare, Medicaid, and Military payments made to any medical provider on your behalf that relate to your use of Roundup, subsequent injury, and relevant treatment and care be identified, negotiated and reimbursed to your health plan. Further, if you are or were private health insurance policyholder, your enrollment materials likely contained language stating that by receiving insurance, you agree that any benefits you receive for which another party is liable are subject to reimbursement. The legal right for both government and private insurance plans to seek reimbursement in injury cases like Roundup is called subrogation. Even if you do not have any outstanding medical bills, the obligation to report to these agencies and plans still exists.
Is there a cap on Medicare’s recovery?
Medicare will not be entitled to recover more than 30% of your gross settlement award, regardless of award size.
Will Medicare deny my future NHL-related treatment as a result of receiving this settlement?
Those Medicare lien obligations will be resolved and reconciled by Medicare under a Global Resolution Model which covers treatment diagnosis care as well as follow up care.
All Roundup Claimants paying Medicare under the Global Model will be approved by Medicare. As such, ARCHER will ensure that Claimants fulfill their Medicare obligations under the settlement so that future Medicare benefits are not impacted for any reasons pertaining to the Roundup settlement. Proof of Claimant satisfaction under the Global Resolution Model will be provided at the end of the settlement and upon payment to Medicare.
I’ve called Medicare or my health plan and they have said I owe nothing or a different amount. Who is correct?
There is a special unit within the Centers for Medicare and Medicaid Services (“CMS”) that manages the mass tort collection program. This unit does not share information with care advocates, front-line customer service personnel, or even the Benefits Coordination and Recovery Center (“BCRC”), which handles liens on other types of personal injury cases for the federal government. Therefore, you may end up contacting the government and getting what seems like a definitive answer that conflicts with what ARCHER or your firm is telling you, but rest assured that the information ARCHER or your firm is providing is up-to-date and more accurate.
When will Medicare be paid and will proof of payment exist?
Funds have been escrowed within the Qualified Settlement Fund (“QSF”) for the specific purpose of paying the total amount due to Medicare. ARCHER will provide proof of payment to your law firm. Once payment has been made, Medicare considers your reimbursement obligation complete and will provide confirmation of such.