Detailed Answer
When you recover a personal injury settlement, Medicaid and Medicare may assert reimbursement rights for medical care they funded. Addressing these liens early preserves more of your net recovery.
Medicaid Reimbursement in Wyoming
Under federal law, Medicaid is the payer of last resort. Once another party (an at-fault driver, employer or insurer) covers your injury, Wyoming Medicaid can file a claim against your settlement. Federal law at 42 U.S.C. §1396k(a) obligates states to pursue these third-party recoveries. In Wyoming, see Wyo. Stat. Ann. Title 42, Chapter 4 for program rules. The state health department will send a lien notice listing conditional payments. You must satisfy or negotiate that lien before distributing settlement proceeds.
Medicare Secondary Payer Rights
Medicare enforces its recovery rights under the Medicare Secondary Payer Act, codified at 42 U.S.C. §1395y(b). When Medicare makes conditional payments for treatment related to your injury, it expects reimbursement from any third-party settlement. Medicare issues a Demand Letter and identifies the amount due. Failure to reimburse on time can trigger interest and penalty charges.
Settlement Strategies
- Notify Medicaid and Medicare early in negotiations.
- Obtain a lien payoff letter to confirm amounts owed.
- Allocate settlement funds specifically to medical bills in your release.
- Negotiate reductions: both programs sometimes accept less than billed charges.
- Work with your attorney to draft an escrow or qualified settlement fund for disputed liens.
Helpful Hints
- Track all medical invoices and payments made by Medicaid/Medicare.
- Request conditional payment statements from Medicare online through the Medicare Secondary Payer Recovery Portal.
- Maintain clear records: date of service, provider and amount paid by government payers.
- Consult a lawyer familiar with government liens to ensure proper compliance.
- Plan your budget: set aside funds for lien repayment before attorney fees and other costs.
Disclaimer: This article is for general informational purposes and does not constitute legal advice. Consult a qualified attorney to address your specific circumstances.