September 28, 2011
Click here for the Risk v. Reward: The LandSafe Appraisal Service Agreement by Manning&Kass, Ellrod, Ramirez, Tresser, Attorneys at Law
August 22, 2011
The Herbert H. Landy Insurance Agency, Inc., of Needham, MA announces their partnership with The Navigators Management Company, Inc., the principal underwriting subsidiary of The Navigators Group, Inc. (NADAQ: NAVG), to offer a national program for accountants professional liability insurance beginning November 1, 2011 for accounting firms with revenues of one million dollars or less. The Landy Agency will also have access to Navigators Pro open brokerage division for larger accounting practices.
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.
July 25, 2011
HEADS UP – MEDICARE IS LOOKING FOR YOU
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
June 14, 2011
Article Source: LiveVal Magazine
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.
Date: Friday, May 20, 2011
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.
May 2, 2011
Numerous studies indicate that there are more women and minorities entering law school and going on to practice law. On The Landy Law Letter, host John L. Torvi, from the Herbert H. Landy Insurance Agency of Needham, Massachusetts welcomes Attorney Catherine M. Stanton from the law firm, Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP, to take a look at the current dynamics of women and minorities in the law. Cathy talks about the current conditions for women and minorities entering into a law practice, the obstacles for minorities or women in advancing to the higher echelons of the profession and what law schools and the legal profession are doing to create greater opportunities for minorities and women lawyers.
Click here to listen to the Podcast.
Special thanks to Legal Talk Network for helping with this Podcast.
February 28, 2011
Getting involved in practice groups or your local bar association can be a huge benefit to your solo practice or law firm. On The Landy Law Letter, host John L. Torvi, from the Herbert H. Landy Insurance Agency of Needham, Massachusetts welcomes Attorney Andrew J. Reinhardt, partner in the Richmond, Virginia law firm of Reinhardt & Harper, to explore benefits of getting involved in specialty practice groups and bar associations. Andrew points out the general differences between a State Bar Association and a Specialty Practice Group, practical reasons why an attorney would want to join a Specialty Practice Group and how his involvement has impacted him professionally.
Click here to listen to the Podcast.
Special thanks to Legal Talk Network for helping with this Podcast.
February 10, 2011
Written by Betsy Magnuson, President, The Herbert H. Landy Insurance Agency, Inc.
Giving up prior acts coverage is risky business.
Don’t be fooled by marketing gibberish implying that you don’t need to maintain your prior acts coverage in your Real Estate Errors & Omissions Insurance policy. YOU NEED IT.
I realize that these are tough economic times, and with the downturn of the market, many real estate appraisers are struggling to survive. However, one of the most important business decisions you can make is to continue your Errors & Omissions Insurance coverage. No one ever thinks they are going to have a claim. However, as long as homeowners continue to struggle to meet mortgage payments and fall short of refinance requirements due to lowered property values, real estate appraisals will be scrutinized and questioned.
Many real estate appraisers assume that if they paid for an insurance policy, they have coverage under that policy forever. This is not true and this is not how claims-made policies work.
If your policy is written on a claims-made basis (most professional liability policies are), your prior acts date is typically the date of the first policy you purchased. Some carriers will offer what is called “full prior acts.” This means that there is no specific date in the past by which your prior acts are limited. Your prior acts date is carried forward each year if you renew your policy without a lapse in coverage. You are then covered back to your prior acts date in the event of a claim, subject to your policy terms, conditions and exclusions.
Let’s demonstrate how a claims-made policy works.
John Smith purchased a real estate appraiser policy February 1, 2000. He renewed his policy each year by February 1 to avoid having a lapse in his coverage. His current policy will have a prior acts date of February 1, 2000. Mr. Smith’s policy would respond to a claim that is reported during his current policy period for work he performed between that date and February 1, 2011, subject to the terms, conditions and exclusions of the policy form.
If Mr. Smith were to switch insurance companies before his current policy expired February 1, 2011, his new carrier should pick up his prior acts coverage back to February 1, 2000, and the new insurance company would respond to new claims reported during the policy period for work done between February 1, 2000 and February 1, 2012.
If Mr. Smith let his policy lapse and did not renew it by February 1, 2011, or went with an insurance company that did not offer prior acts – should he have a claim for work he did between February 1, 2000, and February 1, 2011 – he would have no coverage unless he purchased an Extended Reporting Period Endorsement.
Most claims or complaints are reported several years after the actual appraisal was performed. There are statutes of limitations that typically vary by state and by allegation, which may protect a real estate appraiser from being held responsible for damages. However, there is still the cost of defense, which can far exceed the cost of your insurance contract.
You can purchase an Extended Reporting Period Endorsement from your current carrier during a specified time period if you do not renew your policy, retire, or switch to another carrier who does not provide you with prior acts coverage. It is an extension of time to respond to a claim for work done between your prior acts date and your policy expiration date. Costs vary depending on the insurance company. Some may offer free options for retirees and Death and Disability, as well as options you can purchase for a one-, two- or three-year period of time. An Extended Reporting Period does not cover any services performed in the future. It only provides an extension of time in which to report a claim for work done in the past. It is a one-time option and cannot be renewed once the extended reporting period expires.
The long and the short of it: giving up prior acts coverage may be one of the worst business decisions a professional could make. All those years of maintaining adequate protection by renewing each year and keeping your prior acts coverage would be gone – just when you most need coverage. Maintain your prior acts coverage until you are no longer performing any professional services, then review your policy options and/or discuss with an insurance professional your extended reporting period options.
The terms, definitions and examples of insurance coverage are used here for demonstration only. Insurance policies and coverage can vary widely amongst insurance companies and you should consult an insurance professional and your policy for more information.
January 20, 2011
Date: Jannuary 26, 2011
Start Time: 10:00 AM; End Time: 4:00 PM
Location: West Pasco Board of REALTORS®
5409 Sunset Road
New Port Richey, FL, 34652
Telephone (727) 848-8507
January 20, 2011
Date: Monday, January 24, 2011
Start Time: 8:30 am; End Time: 5:00 pm
Location: Pinellas Realtor Organization, Ulmerton Road, Clearwater, FL
Category: Education
Description:
The SFR certification program is offered by the Real Estate Buyer’s Agent Council
(REBAC) of NAR. The program includes training on how to manage short sale,
foreclosure, and real-estate owned transactions, and provides resources to help
Realtors® stay current on national and state-specific information as the market for these distressed properties evolves.