Articles Posted in subrogation

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…

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’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.…

New Fixed Percentage Option For Medicare’s Recovery Claim The Centers for Medicare & Medicaid Services will be implementing a new and simple fixed percentage option that will be available to certain beneficiaries beginning November 7, 2011. This option is available to beneficiaries who receive certain types of liability insurance (including self-insurance) settlements of $5000 or…

I am attaching below the letter I sent to three members of the North Carolina House Select Committee on Tort Reform. I believe that House Bill 542 may “look” good for business but have the unintended consequence of making North Carolina the WORST place for manufacturing in the entire United States. I’ve inserted a few…

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…

In the matter of Andrews v. Haygood, on December 12, 2008, the NC Supreme Court affirmed the court of appeals opinionwhich rejected the application of Ahlborn v. Arkansas to NC medicaid third party subrogation. Justice Newby wrote the opinion from which Justices Hudson, Brady and Timmons-Goodson dissented. The gist of the majority opinion is that the majority interprets Ahlborn (which…

I received a good question today and thought I would share my thoughts on the issue. The question concerns Medicaid and “med pay”. In NC, Medicaid gets 100% of med pay (first party) insurance proceeds. The problem is that quite often physicians and chiropractors often receive the med pay before the lawyer is involved. Or,…