Articles Posted in lien

If you find yourself in a situation with a personal injury case in North Carolina where Medicaid is claiming a substantial portion of an already limited insurance settlement, and you need to reduce the Medicaid lien, there is a statutory process to request a reduction hearing. The problem is that it is hard to find…

I’ll put the most important thing first, then explain it. This is just my opinion, and applies only to North Carolina law, but since deadlines may be running, I wanted to get it out there. If you settled a case (by minor settlement, signed release, or Industrial Commission approval) in which Medicaid claimed a lien,…

I’m a little late posting this new statute on my blog because I was so involved in getting the new Medicaid subrogation statute trimmed down and written in a way that it would be workable for trial lawyers. These changes were the result of the US Supreme Court Ruling in Wos v EMA issued March 20,…

I found this link with MSPRC’s website and thought it might be helpful to some of you. This link takes you to the PDF lists of all the Medicare diagnosis codes dating back to 2002. http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/codes.html You can download the pdf files and open them in Acrobat and then CTRL F search for the codes…

I received a question by email and it is a good one so I’m going to post the question and the answer: Can a medical provider claim a lien under NCGS 44-49 if the medical bills have been paid by the workers compensation carrier prior to injured worker pursuing a third part claim against a…

If you are interested in hearing how the 4th Circuit came to the decision in E.M.A. v Cansler, wherein the Court held that NC’s Medicaid lien statute was not in compliance with the requirements for subrogation as set out in Ark. Dep’t of Human Servs. v. Ahlborn, 547 U.S. 268 (2006) the audio link is posted below.…

Finally! After about 7 years of multiple protracted litigation on three separate cases, the United States Court of Appeals for the 4th Circuit has established in the matter of E.M.A. v. CANSLER, that Ark. Dep’t of Human Servs. v. Ahlborn, 547 U.S. 268 (2006) is the law of North Carolina and that the NC Supreme Court…

Increasingly, lawyers find that even when an injured client has some type of health care coverage, when the client has been injured by the negligence of a third party, it is often difficult to get the health insurer to pay the bills. Typically, this stems from the Health Insurance contract having language that says the…

Just had a great straight forward question about the interaction of Medicaid Liens, Attorney Fees, and medical provider liens pursuant to NCGS 44-49-50. QUESTION: Is Medicaid’s lien capped at one third of liability proceeds received or half of what is left over after attorney’s fees? In other words, if I am pro-rating a Medicaid lien…

Congratulations to attorney Patrick J. Loughren of Pennsylvania for his victory in Tristani v. Richman, a medicaid subrogation case. I don’t have a lot of time today to dig through this case, which is 50 pages long and denser than a fruitcake, but this is, in my opinion, and “extension” on Ahlborn. also, it addresses…