Disclaimer: This article is for educational purposes only and does not constitute legal advice or establish an attorney-client relationship.
Detailed Answer
In Michigan, the Department of Health and Human Services (MDHHS) can assert a lien for medical assistance it paid on your behalf when you recover from a personal injury claim. The lien protects the state’s interest in recouping expenses from third-party recoveries.
1. Statutory Basis
MDHHS files a lien under Michigan Compiled Law § 400.65 (MCL 400.65). Federal rules require this reimbursement under 42 CFR § 433.137 (42 CFR 433.137).
2. Notice and Timing
MDHHS must send a lien notice within six months after your third-party claim arises, or it forfeits the right to reimbursement from that recovery. Keep a copy of any notice and confirm it is served according to court rules.
3. Determining the Lien Amount
The lien equals the total medical assistance paid by MDHHS for treatment related to your injury. Review the itemized billing records submitted by MDHHS. If you believe charges are duplicative or unrelated, you can challenge specific line items.
4. Allocating Settlement Proceeds
Michigan courts often allow you to allocate a settlement among past medicals, future medical care, pain and suffering, lost wages, and other damages. Since the lien applies only to past medical expenses, negotiate with MDHHS to exclude future medical costs from the lien. Support your allocation with expert medical testimony and detailed damage breakdowns.
5. Negotiation and Reduction
You can negotiate a reduction in the lien amount by arguing that MDHHS overpaid for treatment, that your settlement’s medical component is lower than billed charges, or that equitable considerations—such as legal fees—should reduce the state’s recovery. Submit your settlement breakdown and a written request for reduction to MDHHS.
6. Satisfying the Lien
Before distributing any settlement funds, you or your attorney must obtain a release or satisfaction of lien from MDHHS. The department will issue this once it receives full payment of the valid lien amount. If the dispute remains unresolved, you may need to petition the trial court to determine a fair lien amount.
Helpful Hints
- Document every communication with MDHHS in writing and confirm receipt.
- Get a detailed allocation of damages in your settlement agreement.
- Consult a personal injury attorney experienced in Medicaid lien issues.
- Review your case’s medical records to spot billing errors or unrelated charges.
- File any lien challenges promptly to avoid missing statutory deadlines.