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Medicaid and Medicare Liens

New Egypt, NJ |

How can Medicaid or Medicare legally place a lien on a personal injury settlement to which they have never paid anything out on the injury or relating to the injury?

Attorney Answers 7

Posted

Generally speaking Medicare/Medicaid has a statutory lien against your injury claim if they had to pay anything due to someone else's negligence. If they didn't pay anything related to your injury and your attorney is stating they have to be paid for something you need to sit down and ask your attorney to explain what they being paid and why.

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Posted

Medicare and Medicaid have statutory based liens. In many cases, their immediate recoevery may be limited to the amounts that they have paid for your accident related medical treatment. Medicaid may have a right to collect other amounts from your estate at the time of your death. Either way, the amouts you receive may affect your eligablity for Medicaid in the future. Additonally, Medicare may assert a credit against any future accident related medical treatment expenses. Due to the complicated nature of these types of liens, I strongly recommend that you discuss this matter with your attorney.

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Posted

They cant place a lien for past expenses if they didnt pay any of the bills. Until they send written confirmation they havent paid, most attys and ins cos wont pay or disburse settlement funds. Sometimes it takes awhile to get such confirmation.

Medicare is trying to set up a program to assure it doesnt pay in the future for treating injuries where an ins co settled or verdict gave you money for future medical care. This is complicated and fact dependant.

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thank you

Posted

If Medicare did not pay for any of your treatment that was related to the injury you are being compensated for, then you should question why they would be asserting a lien. Medicaid is different. If they have paid beneifts to you at some point, even if they are not related to your injury claim, they may be entitled to recoup those amounts when you recover money by way of a personal injury settlement. Your lawyer should be able to explain precisely which benefits give rise to valid liens.

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Posted

Bottom line is do not sign the settlement release until your lawyer has resolved this, otherwise, he has no incentive to do so.

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Thank you!

Posted

they are only entitled to be reimbursed for money they paid for medical bills related to the injuries suffered in the accident.

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I agree. Thank you.

Posted

If neither Medicare nor Medicaid actually paid bills for your care then your attorney will have to seek the proof and negotiate. If none paid then ultimately there should be no lien. If however either paid some then they have to be contacted and the requested information provided and the amount payable will be determined and your attorney will be advised. Medicare takes a long time to resolve these issues, Medicaid through the state is easier to deal with and it can be determined faster and easier and can be worked out. This is for your lawyer to resolve on your behalf.

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