Articles Posted in medicaid

Hey wait, when did there get to be multiple insurers providing Medicaid benefits!? And who do I contact to get a Medicaid lien? Great questions! Some answers: Back on Feb. 4, 2019, the North Carolina Department of Health and Human Services announced the selection of Prepaid Health Plans that will participate in Medicaid managed care…

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…

Friends: This post is an update on an earlier post concerning changes to the law of Medicaid subrogation in North Carolina. The earlier post can be seen here: Medicaid: “Ahlborn hearings” are back thanks to the 2018 federal budget which makes Medicaid provide lien reduction hearings again. But watch the deadlines! Here is the short…

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,…

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…