Medicaid/Medicare Liens

Settling Medicaid/Medicare Liens in Personal Injury Cases

New Jersey Legal Malpractice Attorney

Attorneys practicing in the personal injury field are also required to repay their clients’ Medicaid and Medicare liens for the money expended on federally-subsidized health care treatment for the injuries they sustained. Failure to pay back these liens from the money recovered in the personal injury cases will expose the attorneys to personal liability.

The process is quite cumbersome for the law firm. Attorneys must first obtain Medicare information from the client and copy their Medicare cards. They must contact Medicare’s Benefits Coordination and Recovery Contractor (BCRC) and send in an initial notification to Medicare. The BCRC collects the information for Medicare and opens the file with the Medicare Secondary Payor Recovery Center (MSPRC). The MSPRC will require the following information:

  1. Beneficiary Information: Name, Health Insurance Claim Number (HICN), Gender and Date of Birth, Address and Phone number
  2. Case Information: Date of injury/accident, date of first exposure, ingestion or, implant, Description of alleged injury or illness or harm, Type of Claim (Liability insurance, No-Fault insurance, Workers’ Compensation), Insurer/Workers’ Compensation name and Address
  3. Representative Information: Representative/attorney name, Law Firm name if the representative is an attorney, Address and Phone number
  4. Signed Consent to Release and Proof of Representation.

Once Medicare’s BCRC opens the case, a Rights and Responsibilities letter from the Medicare Secondary Payor Recovery Center (MSPRC) is issued to the attorney. The Rights and Responsibilities letter outlines the process. The attorney should also submit Proof of Representation to MSPRC, along with a copy of his retainer agreement if: (a). The retainer agreement is on attorney letterhead or accompanied by a cover note on letterhead, (b). The retainer agreement is signed by the beneficiary, (c). The beneficiary’s name and Medicare Health Insurance Claim Number (HICN) are printed at the top of the form (this may be added after the retainer agreement is signed), and (d). The retainer agreement is signed or countersigned and dated by the attorney.

It is imperative that an attorney pays Medicaid or Medicare that amount owed for medical treatment provided to the client. This amount must be withdrawn from the funds received in settlement of the personal injury claim. If the attorney fails to take this step, he may be liable to the client, to the federal government, or both.

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