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211 Landmark Drive, Suite C2, Normal, IL 61761
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21 More Medicare Tips For 2021
June 2021
In 2020, the Brady, Connolly & Masuda, P.C. Medicare Compliance Department (MCD) provided our top 20 tips and updates for the Medicare Secondary Payer world (https://conta.cc/2T6NjH4). Since then, we have all overcome new obstacles, developed innovative processes, and continued to advance the practice. With 2021 in full swing, the MCD presents 21 more tips and updates for you.
GENERAL INFORMATION:
- Start. Early! The MCD continues to emphasize early investigation into possible Medicare implications for your claims in order to avoid delay in resolution down the road.
- With that said…it is never too late. Whether the claimant is still treating, you have settled the claim, or the permanency portion of the claim has been closed for some time, the MCD can always offer recommendations to resolve possible Medicare-related issues throughout your claims.
- The low-dollar review thresholds for liability, no-fault, and workers’ compensation cases remain $750.00 in 2021.
- Rated ages are not only useful for future medical analyses, but can also decrease potential exposure for other aspects of claims. Please reach out to us if you need assistance with obtaining a rated age.
Two Heads Are Better Than One
June 2021
By: Markeya A. Fowler and Carolyn P. Murray, MSCC
Two heads are better than one! We have all heard this old adage and found it to be true more often than not. Brady, Connolly & Masuda, P.C. is proud to share one such case where two practice groups came together to achieve a great result.
One of the hardest to contain and costliest parts of any workers’ compensation case is the exposure for future medical. That task becomes even more arduous when the claimant is a Medicare recipient. Our attorneys, Markeya Fowler (Workers’ Compensation Litigator) and Carolyn Murray (Certified Medicare Consultant) were faced with this task in a work injury claim. Together, they formulated and implemented a strategy which completely mitigated the future medical exposure for the client.
The claimant alleged that he was involved in two accidents occurring a month apart. He claimed an injury to his shoulder on June 11, 2012 while removing baseboards and to his bilateral hands on July 12, 2012 while prying out tile. As the case developed, we were able to identify evidence that called into the question the claimant’s credibility, as well as the alleged mechanism of injury.
Mechanics Lien Forfeited by Failing to Sue all Necessary Parties
June 2021
The Illinois Appellate Court, First District, recently issued an opinion which should remind contractors that the Illinois Mechanics Lien Act (the “Act”) is strictly construed and the lien can be forfeited when the Act is not properly followed.
In CB Construction & Design, LLC v. Atlas Brookview, LLC, 2021 IL App (1st) 200924, contractor CB Construction & Design, LLC (CB), performed renovation work for premises owner, Atlas. CB claimed that it completed its work but was still owed more than $1 million under the contract. CB filed a mechanics lien. Upon receipt of the lien, Atlas served CB with a Section 34 demand to file suit within 30 days. CB filed suit for breach of contract and enforcement of mechanics lien naming Atlas and “other defendants yet to be determined.”
Atlas then filed a motion to dismiss, arguing that CB failed to name all necessary parties to the mechanics lien action. Specifically, Atlas noted that the property lender, TPG, and rent assignee, Wells Fargo, both had recorded security interests in the property. Yet, the complaint failed to include either entity as defendants.
The Court agreed and granted Atlas’ motion to dismiss. The Court held that Section 11 of the Act requires each claimant to make as parties the owner of the premises, the contractor, all persons in the chain of contract between the claimant and the owner, all persons who have asserted or may assert liens against the premises under the Act, and any “other person against whose interest in the premises the claimant can assert a claim.” These Section 11 entities are referred to as “necessary parties.” In this case, CB’s lawsuit requested sale of the property and a declaration that the lien was “senior and superior” to any interest of any other person or entity. Because both TPG and Wells Fargo held a security interest and rents from the property and would be impacted by such relief, the Court determined that CB was asserting a claim against them and both entities were plainly necessary parties.
Exclusive Remedy Applies – Defendant Had Preexisting Legal Obligation To Pay Workers’ Compensation Benefits
June 2021
In Munoz v. Bulley & Andrews, LLC, 2021 IL App (1st) 200254, Plaintiff was an employee of Bulley & Andrews Concrete Restoration, LLC (“Bulley Concrete”). He sustained a back injury arising out of and in the course of his employment. Workers’ compensation benefits, including medical bills exceeding $76,000.00, were paid by Bulley & Andrews, LLC (“Bulley LLC”), the general contractor for the project. Bulley Concrete was a wholly-owned subsidiary of Bulley LLC.
Plaintiff filed a lawsuit in circuit court against Bulley LLC and other defendants. Bulley LLC moved to dismiss, arguing that it was immune from the lawsuit under the exclusive remedy provisions of the Workers’ Compensation Act (“Act”) (820 ILCS 305/5(a), 11 (West 2018)).
Judge Gillespie agreed, and dismissed Plaintiff’s lawsuit as to Bulley LLC.
Plaintiff appealed, arguing that Bulley Concrete was his employer, not Bulley LLC. The workers’ compensation claim had been made against Bulley Concrete, not Bulley LLC. Plaintiff argued that a parent company is not shielded from a lawsuit filed by an employee of its subsidiary.
Governor Pritzker Vetoes Pre-Judgment Interest Legislation- Revised Bill to be Sent to the Governor
April 2021
As BCM reported previously in January, the Illinois Legislature passed HB3360, which would have imposed 9% per annum pre-judgment interest on all categories of damages in a personal injury action running from the date the alleged tortfeasor has notice of the injury. In our prior alert, we highlighted many issues with the Bill, including its broad reach and punitive nature. We can now report that Governor Pritzker has vetoed HB3360. However, the Governor did indicate he would consider compromised legislation.
Indeed, compromised Senate Bill 72 has now been submitted to the Governor. Under Senate Bill 72, pre-judgment interest would (1) be at lower rate of 6% per annum, (2) be cut off at five years in all events, (3) start running from the date of the filing of the Complaint, (4) be tolled in the event of a voluntary dismissal and (5) not apply to claims against public entities. Senate Bill 72 is also markedly different from HB 3360 because it provide a mechanism for settlement offers. Specifically, if the defendant does better at trial than an offer made within a certain time prior to trial, interest is not applied. It also provides that interest does not apply to punitive damages, sanctions, statutory attorney’s fees, statutory costs and the amount of the highest timely-written settlement offer. However, Senate Bill 72 retains the provision allowing pre-judgment interest on non-economic damages.
Commissioner Appointments and Realignment of Commission Panels; Arbitrator Reassignment
March 2021
On March 19, 2021, Governor Pritzker announced the following appointments to the Commission. The following biographies come from the Governor's press release.
Deborah Baker will serve on the Workers' Compensation Commission as a Labor Commissioner. Baker was previously Assistant Deputy Chief Legal Counsel and Ethics Officer at the Illinois Department of Corrections. Prior, she was Litigation Counsel and Compliance Counsel at UpRight Law and served as Assistant Attorney General at the Office of the Illinois Attorney General. Baker earned her bachelor's from the University of New Mexico and Master of Arts and Juris Doctor from Loyola University Chicago.
Barbara Flores will continue to serve on the Workers' Compensation Commission as a Public Commissioner. Flores was previously an Arbitrator at the Illinois Workers' Compensation Commission. Prior, she was Corporate Counsel at Alden Management Services, Inc., and served as Final Agency Decision Writer at U.S. Postal Service, National Equal Employment Opportunity Investigative Services Office. She has extensive legal experience as a Law Clerk and is actively involved in scholarship and professional organizations. Flores earned her Bachelor of Science from the University of Illinois at Urbana-Champaign and Juris Doctor from the Chicago-Kent College of Law.
Christopher Harris will serve on the Workers' Compensation Commission as an Employer Commissioner. Harris was previously an Arbitrator at the Illinois Workers' Compensation Commission. Prior, he was Owner and Managing Attorney at Shield Law Firm LLC. Harris has additional legal experience as general counsel. Harris earned his Bachelor of Arts from the University of Illinois at Urbana-Champaign and Juris Doctor from the University of Illinois at Urbana-Champaign College of Law.
| 10 South LaSalle Street, Suite 900 Chicago, IL 60603 Phone: 312-425-3131 |
| 211 Landmark Drive, Suite C2 Normal, IL 61761 Phone: 309-862-4914 |
| 1015 Locust Street, Suite 914 St. Louis, MO 63101 Phone: 314-300-0527 |
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