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Birmingham Bar Association Bulletin Winter 2015

Forensic Accounting/ Medicare The Value of Using the Services of a Forensic Accountant In Legal Matters continued from page 17 ance of evidence to win the case to mitigating damages, or to perhaps allowing either side to get a more objective handle on the issues and ultimately getting the case to settle, thereby avoiding the cost of a trial. For example, in a case where the attorney was defending his client in a shareholder dispute, the largest part of the dispute involved the stock repurchase price, which was to be determined pursuant to a previously executed buy sell agreement. According to the buy sell agreement the repurchase price was based on the results of a third party valuation report, which I was asked to review. While I found the substance of the valuation report to be reasonable, my experience as a forensic accountant allowed me to uncover several errors, which resulted in an overstated repurchase price. After reporting these errors, the original valuator recalculated the repurchase price of the stock, thus dissipating any significant differences between the parties. The end result was that the dispute was settled and the cost of a lengthy trial was averted. In another situation I received a call from an attorney for the defense in a product liability claim. The attorney advised me that the claimant was in the process of filing a legal action against his client and that he had been hired to evaluate the veracity of the alleged claim. The attorney gave me the claimant’s calculations which I studied after which I submitted a list to him. This list asked for certain internal documents from the claimant, in order to see if they supported the alleged damage claim. In response, the claimant did produce many of the documents that were requested. However, the claimant was still reluctant to produce certain other documents, which would have clearly supported the amount of the alleged claim. I then indicated to legal counsel that the opposing side’s resistance to producing these documents could be an indication that the amount of damages claimed was without merit. The attorney was able to use this new found information to effectuate a favorable settlement. In each of these illustrations the use of a forensic accounting expert added an extra dimension to the legal team’s overall effectiveness, thereby getting a favorable result. This is something that should be kept in mind whenever faced with the cost-benefit analyses of whether to use a forensic accountant.  In closing, there are many more examples showing how a forensic accounting expert contributed significantly to the legal team’s performance and end result. However, it should always be kept in mind that selecting the right professional with the right experience, background, and credentials is as critical to this process as is the decision to use someone in the first place. G About the author: Bob Mayeri is a certified public accountant licensed in the states of California and Alabama. Mr. Mayeri also holds credentials as a certified valuation analyst (CVA) from the National Association of Certified Valuators and Analysts (NACVA), and Master Analyst in Financial Forensics (MAFF) from Consultant’s Training Institute (CTI). He can be reached via e-mail at RMayeri2@gmail.com, or via telephone at (818) 497-1200. Updates To Future Medicals And Medicare Set-Asides continued from page 27 •  a “hearing” by an administrative law judge, •  a “review” by the Departmental Appeals Board’s Medicare Appeals Council, and •  judicial review.3 An attorney may request an appeal on behalf of an applicable plan, as long as there is proper proof of representation. The appeal may involve the amount of the Medicare lien and/or the existence of the lien but may not involve which entity is the responsible party. Medicare beneficiaries, liability insurers and attorneys now have a process to voice their disagreement with the Medicare conditional payment/formal demand amounts. Stay tuned for additional updates and changes as there are undoubtedly more coming. G (Endnotes) 1. http://www.reginfo.gov/public/do/ eoDetails?rrid=123255 2. Sanderson, Heather Schwartz, “CMS Withdraws Rulemaking on MSP and Future Medicals,” http:// www.workerscompensation.com/ compnewsnetwork/workers-compblogwire/ 19989-cms-withdrawsrulemaking on-msp-and-future-medicals. html. 3.https://www.cms.gov/Medicare/ Coordination-of-Benefits-and-Recovery/ InsurerServices/Downloads/Appeal- Rights-for-Applicable-Plans.pdf 32 Birmingham Bar Association


Birmingham Bar Association Bulletin Winter 2015
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