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생산성 및 협업 · SKILL.md

lien-resolution-summary

lien-resolution-summary

Generates a structured internal lien resolution summary for personal injury settlement cases. Triggers when resolving liens post-settlement, preparing settlement distribution statements, or auditing lien payoffs across health insurance subrogation, Medicare/Medicaid, hospital liens, workers' comp, and ERISA plans.

Independent GitHub snapshot · Automated classification · Original documentation governs

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name: lien-resolution-summary language: en description: Generates a structured internal lien resolution summary for personal injury settlement cases. Triggers when resolving liens post-settlement, preparing settlement distribution statements, or auditing lien payoffs across health insurance subrogation, Medicare/Medicaid, hospital liens, workers' comp, and ERISA plans. tags:

  • litigation
  • summarization
  • summary

Lien Resolution Summary

Internal tracking memorandum documenting identification, negotiation, resolution, and satisfaction of all liens against personal injury settlement proceeds. Mark output as privileged/confidential attorney work product — do not distribute to lienholders.

Prerequisites

Gather before starting:

  1. Settlement agreement — gross amount, distribution terms, holdback provisions
  2. Lien demand letters/notices — from all asserting parties
  3. Medical billing records — itemized statements, EOBs per lienholder
  4. Negotiation correspondence — reduction requests, responses, final agreements
  5. Satisfaction documents — releases, discharges, confirmation letters (if available)

Workflow

Step 1: Executive Overview

Produce a header table:

FieldContent
Case captionParties, court, case number
Settlement dateDate funded
Total settlementGross amount
Aggregate liens assertedSum of initial claims
Aggregate liens resolvedSum of final payments
Total savingsDollar amount + percentage
Net to clientAfter liens, fees, costs
Resolution statusAll resolved / X pending

Step 2: Classify Lienholders

Categorize each lien:

CategoryLegal Basis
Private health insuranceContractual subrogation, policy terms
Medicare/Medicaid42 U.S.C. § 1395y(b) (MSP)
Hospital/provider statutoryState hospital lien statutes
Workers' compensationState WC subrogation statutes
ERISA plans29 U.S.C. § 1132(a)(3); US Airways v. McCutchen
Other (VA, Tricare, disability)Varies by program

For each lienholder record: legal name, claim/reference number, contact, legal basis (statutory cite or policy provision), and priority position.

Step 3: Lien Detail Table

For each lien, produce a row covering:

  • Lienholder — name + category
  • Initial amount claimed and date of notice
  • Calculation method — full benefits paid / % of settlement / other
  • Disputed items — unrelated treatment, duplicates, excessive charges
  • Reduction arguments — made-whole, common fund, comparative fault, fee sharing, statutory caps
  • Legal authority cited — statute, case law, policy language
  • Final agreed amount and reduction achieved ($ + %)
  • Payment terms — due date, method, payee
  • Conditions — release required, dismissal of enforcement action
  • Satisfaction status — obtained/pending with date; identify supporting docs

Step 4: Outstanding Issues

For unresolved liens or contingent claims, document:

  • Unresolved liens — delay reason, negotiation status, anticipated timeline
  • Potential future claims — Medicare conditional payments not yet identified, non-responsive carriers
  • Holdback funds — amount reserved, release conditions
  • Financial exposure — worst-case liability per outstanding item

Step 5: Financial Summary

Reconciliation table (must tie to settlement distribution statement):

Line ItemAmount
Gross settlement$
Less: Attorney fees($ )
Less: Costs($ )
Less: Lien payments (itemize each)($ )
Net to client$
Total liens initially claimed$
Total liens paid$
Total negotiated savings$ (XX.XX%)

Step 6: Compliance Checklist

  • Medicare Section 111 reporting completed (42 U.S.C. § 1395y(b)(8))
  • CMS final conditional payment letter obtained
  • ERISA plan notification/appeal deadlines met
  • State hospital lien satisfaction filed with court/recorder (if applicable)
  • All lien releases executed and originals filed
  • Client provided final distribution breakdown
  • Records retention schedule documented

Pitfalls and Checks

  • Medicare liens: non-negotiable on validity — only dispute specific line items (unrelated treatment, amount errors). Use BCRC process; document final conditional payment from CMS.
  • Made-whole doctrine: available in most states for equitable subrogation; generally unavailable against ERISA plans (FMC Corp. v. Holliday; US Airways v. McCutchen). Verify state law.
  • Common fund doctrine: argue proportionate fee/cost reduction. Many states require insurers to share procurement costs. Not applicable to Medicare.
  • State lien caps: several states cap hospital lien amounts or provide statutory reduction formulas. Cite the specific statute.
  • Precision: all dollar amounts stated exactly; percentages to two decimal places. Every figure must reference source documentation.
  • Metadata: include preparer name, date, and version number on every draft.
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