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Civil Litigation

CMS to Demand Section 111 Reporting of Funds Set Aside for Future Medicals in Workers’ Compensation Settlements

The Centers for Medicare and Medicaid Services (CMS) is expanding the existing Section 111 reporting process to capture information on all workers’ compensation claims involving Medicare beneficiaries that receive a settlement (i.e., TPOC) and funding for a Workers’ Compensation Medicare Set-Aside (WCMSA), regardless of whether the workers’ compensation settlement was reported to CMS under the […]

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General Legislature Passes Significant Changes to Uninsured and Underinsured Motorist Law

By Allen C. Smith, Brooks P. Miller, Julianna Grant, and Austin R. Walsh On September 22, 2023, Senate Bill 452, An Act to Make Various Changes to the Insurance Laws of North Carolina, to Amend the Insurance Rate-Making Laws, and To Revise High School Interscholastic Athletics, was presented to Governor Roy Cooper for signature. Because […]

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Centers for Medicare and Medicaid Services (CMS) Maintains $750.00 “Low Dollar” Reporting Threshold

The SMART Act requires CMS to annually review the costs associated with the collection of Medicare conditional payments and set forth a threshold amount applicable to settlements, judgements, awards, or other payments (TPOC amount) for which it will not seek recovery. The threshold amount for 2023 was $750.00. On February 14, 2024, CMS announced the […]

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Rob Wilson Appointed as Hedrick Gardner’s Raleigh Office Managing Partner

January 2024 — Hedrick Gardner Kincheloe & Garofalo LLP is proud to announce Rob Wilson has been appointed as the firm’s new managing partner of its Raleigh office, effective January 1, 2024. Wilson will succeed Patricia Shields, who has served as managing partner since 2021. In his new role, Wilson is committed to continue the […]

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The Centers for Medicare and Medicaid Services (CMS) Confirms Civil Monetary Penalty (CMP) Rules Regarding Mandatory Insurer Reporting for Non-Group Health Plans (NGHP)

CMS held a webinar on January 18, 2024, where it provided clarification of the rules regarding the issuance of CMPs for late Section 111 reporting of the ongoing responsibility for medicals (ORM) and total payment obligations to a claimant (TPOC). The PowerPoint presentation should be posted on CMS’ website in two weeks. In sum, the […]

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Hedrick Gardner Recognized as a Best Law Firm by U.S. News – Best Lawyers® 2024

November 2, 2023. Hedrick Gardner Kincheloe & Garofalo LLP received several top rankings in the U.S. News – Best Lawyers® 2024 “Best Law Firms” report. The firm received Tier 1 regional rankings, the highest category awarded, in eight categories. The full firm report is as follows: Metropolitan Tier 1 Charlotte: Raleigh: Columbia (SC): Metropolitan Tier 2 Charlotte: […]

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CMS Increasing Threshold for Liability Settlements – Fixed Percentage Option

The Fixed Percentage Option Threshold will Increase to $10,000.00 for Liability Settlements on October 2, 2023 says The Centers for Medicare & Medicaid Services (CMS) By Shannon Metcalf Since November 7, 2011, the Centers for Medicare and Medicaid Services (CMS) has permitted a Medicare beneficiary to elect to resolve his/her conditional payment claim in liability […]

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Hedrick Gardner Recognized as a Best Law Firm by U.S. News – Best Lawyers® 2023

November 3, 2022. Hedrick Gardner Kincheloe & Garofalo LLP received several top rankings in the U.S. News – Best Lawyers® 2023 “Best Law Firms” report. The firm received Tier 1 regional rankings, the highest category awarded, in eight categories. The full firm report is as follows: Metropolitan Tier 1 Charlotte: Raleigh: Columbia (SC): Metropolitan Tier 2 Charlotte: […]

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NC Court of Appeals Clarifies Calculation of Underinsured Motorist Coverage

by Austin Walsh On 5/3/22, the North Carolina Court Appeals published its decision in Tutterow v. Hall, et al. and changed the way Underinsured Motorist (UIM) carriers calculate the coverage available for UIM claims.  The holding gives UIM carriers a credit for all liability policies when tendered, not just the first liability policy that offers […]

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N.C. Farm Bureau v. Dana: Bringing Common Sense Back to Underinsured Motorist Law

by Austin R. Walsh North Carolina – On 12/17/21, the NC Supreme Court issued its opinion in North Carolina Farm Bureau Mut. Ins. Co., Inc. v. Dana i, which clarifies the maximum underinsured motorist (UIM) coverage available to claimants regardless of whether the liability coverage was exhausted based on the per-person or per-accident policy limits. […]

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