Professional Liability Insurance For Members of The Massachusetts Society of Enrolled Agents

The Massachusetts Society of Enrolled Agents is pleased to announce that the Herbert H. Landy Insurance Agency of Needham, Mass., has joined forces with the Massachusetts Society of Enrolled Agents to act as the Preferred Provider of Professional Liability insurance for members.

The Landy Agency is a national leader in providing insurance for tax and accounting professionals and was the first company to specifically develop a professional liability insurance plan for accounting professionals in 1962. The Landy Agency provides state of the art coverage features with very competitive premiums and prompt, personalized service.

“Clearly, in this era of litigation, it’s important for Enrolled Agents to have access to high quality, affordable protection for their personal and professional assets,” said Shantilal Patel, president of the Mass. Society of Enrolled Agents. “At MaSEA, we’re committed to giving our members the best array of services and benefits. That’s why we’re proud to have Landy Insurance as our Preferred Provider.

Coverage is available for practices of all sizes and for a variety of professional services, including tax preparation, bookkeeping, investment advisement, fiduciary services, pro bono work and more. Security
incident protection, Non-Profit Directors & Officers coverage, subpoena assistance and disciplinary proceeding coverage are some of the many expanded coverage features.

In addition, The Landy Agency will also be supporting the Massachusetts Society of Enrolled Agents and its members by providing risk management materials, conference and meeting assistance and other supportive services.

Massachusetts Society of Enrolled Agents members will also have access to Business Owners’ coverage for office general liability and property protection as well as competitively priced workers’ compensation insurance.

With decades of underwriting experience, local, personal and professional service and exceptional insurance coverage, the Landy Agency welcomes the opportunity to provide its services to the Massachusetts Society of Enrolled Agents and its members.

To learn more about the Landy Agency, its insurance plans or to apply for coverage, contact John Torvi at johnt@landy.com or at 781-292-5417, or visit the company at www.landy.com.

To learn more about the Massachusetts Society of Enrolled Agents, visit http://www.maseaonline.org.

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The Herbert H. Landy Insurance Agency of Needham, MA, congratulates Gail E. Bellefontaine, Vice President of Finance and Operations, on her 25th year of service to the company.

Gail joined the Landy Agency in March of 1987 following a position with the Sun Financial Group. She originally worked in the company’s accounting department and now manages both the accounting and processing departments for the Landy Agency. Her responsibilities are varied and include all the financial and human resource obligations of the company. She was promoted to Vice President of Operations and Finance in 2007.

Please join us in congratulating Gail for achieving this important milestone in her 25 years of dedicated service to and accomplishments on behalf of the Herbert H. Landy Insurance Agency.

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The Herbert H. Landy Insurance Agency will be participating in the Core Law and Code of Ethics Continuing Education seminars for members of The Real Estate Association of Lake & Sumter Counties (RALSC).

What: Understanding your Errors & Omissions Insurance

When: Thursday March 8, 2012; 8am – Noon, and 1Pm – 4PM

Where: The Real Estate Association of Lake & Sumter Counties (RALSC)
office in Tavares, FL

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The Herbert H. Landy Insurance Agency developed the first professional liability insurance program specifically created for accounting professionals in 1962. For the past several years, that program was underwritten by General Star National Insurance Company, which has announced it will be exiting the professional liability insurance market for accountants and tax preparers.

“The Herbert H. Landy Insurance Agency and Navigators Management Company share tremendous experience in successfully underwriting and managing professional liability insurance programs”, notes Betsy A. Magnuson, President of the Herbert H. Landy Insurance Agency. “Our mutual emphasis on offering a high quality, cost-effective program for accountants’ professional liability insurance will provide significant opportunities for our national network of insurance producers.”

In addition to expanded coverage options and features, the program will now offer an “EXPRESS” application with a two year policy option. The client qualifies for coverage by answering a brief series of questions on the self-rating application, making the process quick and easy for insureds and producers alike.

Coverage for the Accountants Professional Liability Insurance program is available for accountants and tax professional businesses of all sizes and will be available in all states excluding Louisiana and Alaska.

For more information, contact John Torvi (johnt@landy.com, 781-292-5417) or Betsy A. Magnuson (betsy@landy.com, 781-292-5408) or visit our website at www.landy.com.

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by: Michael E. Civittolo, Esq.

I: INTRODUCTION

This article discusses some of the significant issues facing the practitioner handling a case in which Medicare’s interests are involved. For the reasons which follow, you will see that failure to spot compliance issues and then deal with them appropriately can have serious adverse consequences, not only for your client, but also for you personally.

II: MANDATORY INSURANCE REPORTING

The Medicare and Medicaid SCHIP Extension Act (“MMSEA”) was passed in 2007. Section 111 was included in the Act to create mandatory reporting of payments by so called Responsible Reporting Entities to medicare beneficiaries in personal injury and workers compensation cases. Responsible Reporting Entities face fines of $1,000 a day per claim for failure to report. The magnitude of the potential exposure from failure to report should ensure compliance and the amount of data should provide the Centers for Medicare and Medicaid Services (“ CMS”) the information necessary to carry out its duties much more effectively. Although section 111 reporting in liability cases has been delayed, under existing regulations if a primary payer knows that medicare has paid for treatment for which the primary payer has paid or should have paid, it must notify CMS of its primary payment responsibility and provide “information about the underlying MSP situation.”

III: THE MEDICARE SECONDARY PAYER STATUTE (“MSP”)

Medicare is prohibited from providing coverage to a beneficiary in situations where another applicable plan has paid or is reasonably expected to make payment promptly. Medicare is, however, allowed to make conditional payments subject to reimbursement if there is a recovery by the beneficiary. Although Medicare’s right to reimbursement is many times referred to as a lien, it is actually a right of recovery which arises by operation of law at the time the beneficiary receives payment. All parties sharing in the proceeds used to resolve the claim are personally liable for the entire amount of reimbursement due to the Federal Government. Quite simply, not only the medicare beneficiary but also the beneficiary’s attorney, medical providersand the primary payer are jointly and severally liable for the entire amount.

The collection tools available to medicare are formidable:
1.) It may offset the amount it is due against money the beneficiary is entitled to receive from the Federal Government.
2.) It may bring an action for double damages against any responsible party.
3.) It may bring an action under the Federal False Claims Act for treble damages plus a civil penalty of $5,000 to $10,000.
4.) It may join or intervene in the relevant action
5.) It may pursue its own separate right of subrogation.

The MSP statute also establishes a private cause of action for double damages in the case of a primary plan which fails to make payment or appropriate reimbursement.

Besides facing an action from the United States Government, the Federal False Claims Act also provides for Qui Tam actions by private parties to enforce the government’s rights. These actions could be quite profitable for those who pursue them.

The claimant’s attorney is also exposed to a malpractice action for the client’s losses and a disciplinary complaint for failure to protect the interests of Medicare. See Ethics Advisory Panel Opinion No. 2007-02.

It may offset the amount it is due against money the beneficiary is entitled to receive from the Federal Government. It may bring an action for double damages against any responsible party. It may bring an action under the Federal False Claims Act for treble damages plus a civil penalty of $5,000 to $10,000. It may join or intervene in the relevant action. It may pursue its own separate right of subrogation.

IV: ADMINISTRATIVE REMEDIES

Beneficiaries may petition for a full or partial waiver of medicare’s right of reimbursement. In addition, your client may seek to compromise medicare’s claim. A request for compromise may be made before or after settlement of the underlying claim.

The rules and procedures governing these remedies are beyond the scope of this article. Obviously obtaining a waiver or reduction of the amount owed could be instrumental in resolving certain cases.

When medicare compliance issues are implicated in your case, standard form or boiler plate releases are probably insufficient. Settlement documents should precisely identify the injuries released since the scope of the obligation to CMS is determined by the injuries for which compensation is received. Other specific provisions may also be necessary.

VI: MEDICARE SET-ASIDE ARRANGEMENTS

Your client may require future treatment for the injuries sustained as a result of the claim. If so and the medical expense relating thereto would be covered by Medicare, you may have to set aside an appropriate amount of money to pay for the treatment. Failure to do so could result in Medicare’s refusal to pay for such treatment later or if payment is made, CMS may treat it as a conditional payment subject to reimbursement. CMS will review for approval proposed set-asides in Workers Compensation cases that meet certain thresholds established by CMS. Proposed liability set-asides are reviewed within the discretion of the regional office. Even if CMS declines to review a proposed set-aside, the duty to provide for future medical expenses is not relieved.

VIII: CONCLUSION

The law and best practices in this area continue to evolve as CMS issues additional memos and alerts and appellate decisions are issued. For the reasons stated above, you must ensure that your office makes compliance an ongoing priority.

Michael E. Civittolo, Esq. has received the Medicare Set-Aside Consultant Certified designation and is a member of the National Alliance of Medicare Set-Aside Professionals. He may be reached at (401) 739-6700 x6 with any questions.

The Rhode Island Supreme Court licenses all lawyers in the general practice of law. The court does not license or certify any lawyer as an expert or specialist in any particular field of practice.

Michael E. Civittolo
Attorney at Law
Airport Professional Park
2374 Post Road, Suite 106
Warwick, Rhode Island 02886
Telephone: (401) 739-6700 ext.6
mcivittolo@lawrencelawoffices.com

SUMMARY OF PROFESSIONAL EXPERIENCE AND QUALIFICATIONS

• Medicare Secondary Payer compliance including conditional payment claim resolution; petitions for waiver and compromise; drafting of case specific settlement documents; preparation of medicare set-aside arrangements and trusts; preparation of qualified settlement fund trusts; preparation of medicare set-aside special needs trusts; benefit determination and government benefits preservation

• Consultant to plaintiffs and defendants in Medicare Secondary Payer compliance

• Extensive litigation experience as both plaintiff and defendant

• Extensive arbitration and mediation experience

PROFESSIONAL HISTORY

• Private Practice, October 1977 to present concentrating in medicare secondary payer compliance, personal injury, workers compensation and insurance defense

• Part time attorney working for the R.I. House of Representatives, February 1997 to present

• Member of The National Alliance of Medicare Set-Aside Professionals

• Member of Rhode Island bar

• Member of bar for U.S. District Court for the District of R.I.

SIGNIFICANT ACHIEVEMENTS

• Earned Medicare Set-Aside Consultant Certified credential from the International Commission on Health Care Certification

• Twice selected as one of five finalists by Judicial Nominating Committee for position of Associate Justice of the Rhode Island Superior Court

• Appointed to approved alternative dispute resolution panels byChief Judge of the United States District Court and Presiding Justice of the Superior Court

• Selected as chairperson of membership committee of the National Association of Medicare Set-Aside Professionals

EDUCATION

• University of Rhode Island, Bachelor of Arts in Economics, 1973

• Western New England School of Law, Juris Doctor, 1977

COMMUNITY SERVICE

• Friends of Hasbro Children’s Hospital Volunteer Group

• St. Anthony’s Church Kitchen Ministry

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Faulty appraisals are still a problem for lenders and realty agents who are struggling to put together deals in the first place. Lenders are now requiring a handful or more comparables when three used to be sufficient. This makes it even more difficult to complete the valuation process, and this new system holds back the “ebb and flow” of the process.

There isn’t always a direct match in appraisals, so common sense needs to be used in situations that are a little more difficult. Transparency won’t help when it is impossible to achieve. Lenders agree with the realtors, but they also support their decisions as far as valuation regulations go. At NAR’s midyear legislative meetings, many of these points were brought up and contended as well as supported. Ron Phipps, NAR president, framed the Realtors’ problem concisely and said that they are “a raw nerve for us.” David Stevens, president of the MBA explained the lenders’ side and also noted that it is against appraisal standards for someone to value a property in an area in which he or she is not familiar. Martin Eakes, co-CEO of the Center for Responsible Lending, suggested that banks, servicers, and investors be barred from having ownership interest in appraisals or AMCs; he noted this as a conflict of interest. One problem remains: the market. Though underwriters have tightened their practices and are improving their work, potential buyers are getting nervous and intimidated by the current market, meaning improvements are going to be slow.

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Start Time: 9:00 am

Location: Ocala/Marion Association of Realtors

Description:
If you are involved in SHORT SALES or FORECLOSURES, you should attend this important informational presentation. In Effect now….There are Federal Trade Commission regulations which require additional disclosures to sellers by REALTORS in ALL short sale transactions where they may be providing short sale negotiation services.

Presented By:
Attorney, Hank Sorensen
Tampa, Florida
A Real Estate Service-Oriented Firm, The firm was founded with the understanding that real estate brokers and associates often need legal assistance in their daily activities. With the numerous state and federal laws that govern the brokerage industry, we understand the need for quick and correct legal advice to preserve the quality of real estate transactions. The goal of the firm is to provide the highest caliber legal counsel in a prompt and efficient manner in order to streamline brokerage operations.

Avoiding Litigation from Foreclosure / As Is Sales
Presented by: Joseph Flynn, The Herbert H. Landy Insurance Agency
Joe will be speaking on the following topics: Important Information for professionals involved in Real Estate Transactions. The Threat of Claims from Foreclosures and Avoiding As Is Sales. Joe is a frequent contributor to professional insurance publications and industry guest speaker. He has been active within the Insurance industry specializing in Professional Liability insurance for more than 25 years.

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Click here to listen to the Podcast.

Special thanks to Legal Talk Network for helping with this Podcast.

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Click here to listen to the Podcast.

Special thanks to Legal Talk Network for helping with this Podcast.

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