The Lien Stack: When You're Not the Only One Waiting
Golden Pear Provider Corner
In Episode 6 of Golden Pear Provider Corner, titled "The Lien Stack: When You're Not the Only One Waiting," we delve into the complexities of lien stacks in personal injury settlements.
As your host, I guide you through the intricate layers of claims that precede a provider's payment, from attorney fees to Medicare, Medicaid, and ERISA plans. Discover the strategic importance of negotiating within the provider's own layer—the Letter of Protection—and how operational stability can enhance your negotiating power.
Learn how Golden Pear's healthcare solution can alleviate cash flow pressures, enabling better lien outcomes.
Join me as we unpack the nuances of lien stacks and explore how to maintain financial stability amid the complexities of PI settlements. Tune in to understand how timing and leverage can impact your practice's financial health.
Sources
- Medicare Secondary Payer Act, 42 U.S.C. § 1395y(b); 42 C.F.R. § 411 et seq.
- *Arkansas DHHS v. Ahlborn*, 547 U.S. 268 (2006)
- *Gallardo v. Marstiller*, 596 U.S. 420 (2022) — 7-2 decision
- *U.S. Airways, Inc. v. McCutchen*, 569 U.S. 88 (2013)
- CMS WCMSA Reference Guide v. 4.2 (Jan. 2025) — $0 MSA reviews ending July 17, 2025
- CMS Section 111 reporting expansion, effective April 4, 2025
- Illinois Health Care Services Lien Act, 770 ILCS 23/1 et seq. — all health-care liens combined capped at 40% of recovery; combined attorney fees + liens capped at 70%
- Illinois Supreme Court rulings on common fund non-application to hospital and health-care provider liens (Hinshaw & Culbertson healthcare alert; ISBA Illinois Bar Journal coverage)
- California CCP § 3040 — health plan lien negotiation framework
- Florida HB 837 (signed March 24, 2023); Georgia SB 68 (signed April 21, 2025); Louisiana 2025 tort reform (effective Jan. 1, 2026)
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