Disclaimer: This article is for educational purposes and does not constitute legal advice. Always consult a qualified attorney about your specific situation.
Detailed Answer
In South Carolina, the Department of Health and Human Services (SCDHHS) can assert a lien on any personal injury settlement or judgment to recover Medicaid benefits it paid on your behalf. This right arises from federal law (42 U.S.C. § 1396k) and is implemented by state statute. Under SC Code § 44-6-620, SCDHHS may record a lien with the county register of deeds where you reside or where the settlement occurs.
Here’s how the process typically works:
- Identify Medicaid payments: Gather records of all medical expenses Medicaid covered for your injury.
- Notice of claim: Once you file suit or enter settlement negotiations, SCDHHS must notify you of its lien amount. If you haven’t received notice, request a detailed statement of benefits from SCDHHS.
- Allocation of settlement: Your settlement agreement should separately state the portions allocated to medical expenses, lost wages, pain and suffering, and future care. Courts respect itemized allocations when assessing the lien amount.
- Compromise request: Under SC Code § 44-6-650, you can petition SCDHHS to accept less than the full lien amount if you demonstrate that full recovery would cause financial hardship or unfairly diminish your non-medical damages. SCDHHS generally has 180 days to respond.
- Escrow or court approval: If you cannot reach an agreement, you may place the disputed funds in escrow pending judicial resolution. A judge may approve a compromise and order release of the remainder.
- Payment and lien release: After you pay the approved lien amount to SCDHHS, it must issue a written release of lien to you and the court or escrow agent.
South Carolina law also limits attorney’s fees against the lien. If your lawyer’s fee is a percentage of the total settlement, the lien amount reduces proportionally. Always document fee arrangements and settlement allocations in writing.
Helpful Hints
- Request a detailed benefits statement early from SCDHHS to confirm all paid amounts.
- Itemize your settlement to show exactly what portion covers medical bills.
- Consider a compromise request if the lien threatens to wipe out non-medical damages.
- Work with your attorney to escrow disputed funds rather than delay settlement.
- Keep records of all correspondence with SCDHHS to track deadlines and responses.
- Ask about state rules on attorney’s fees to ensure fair pro rata reduction of the lien.