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My Client is a Medicaid Beneficiary?

Who do you contact when you suspect your new client is a Medicaid beneficiary?  Why do you have to contact that agency?

When a new client steps into your office for a personal injury case it is important to determine who paid for his or her medical care.  If you get this healthcare insurance information early on, it will help you efficiently resolve any subrogation issues that the medical providers assert on your client’s eventual recovery.  The Federal Medicaid statute requires states to ascertain the legal liability of third-parties so that it may pay for care and services rendered under the Medicaid program, and to pursue recovery to the full extent of such legal liability.  The reason behind this is to preserve the Medicaid trust resources so those beneficiaries that do not have alternate coverage will continue to receive benefits.  Essentially, the state Medicaid agencies must place a lien on the case.

Under Federal Law, a Medicaid recipient must assign to Medicaid any rights to pay medical care paid for by a third-party.  This language is contained in both federal and state statutes and is an automatic assignment.

A Medicaid lien is limited to those injury-related medical expenses paid.  Any unrelated payments must be excluded from the lien.  Therefore, if a beneficiary was receiving medical care for non-injury related health issues those charges cannot be included in the lien.  The Medicaid lien is further limited to only the portion of settlement for medical payments (See Arkansas Dept. of Health and Human Services, et al. v. Ahlborn).  In an effort to collect on the lien, the Medicaid recipient and usually his attorney, has a duty to cooperate in the lien resolution process.  This process can be frustrating, time-consuming, and often costly.

The Medicaid Lien process is statutory.  This means that each state has its own office that handles Medicaid lien recoveries.  The first step in any case involving a Medicaid recipient is to notify the state office that handles liens.

A lien resolution provider can handle this process from start to finish for you and your client.  The general process in each state is similar.  You may consider contacting LRS for assistance to protect your rights, and more importantly, so that your client’s settlement is not consumed by the lien.

If you have any questions regarding your state’s Medicaid lien process, or, would like assistance in lien resolution, please contact us.

Marcy Spitz
Co-Founder Lien Resolution Services

This Blog/Web Site is made available by the publisher for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog site you understand that there is no attorney client relationship between you and the Blog/Web Site publisher. The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.


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