Disclaimer: This article is for educational purposes only and does not constitute legal advice. Consult a qualified attorney for advice regarding your situation.
Detailed Answer
1. What Is a Medicaid Lien?
In Connecticut, when Medicaid pays for medical treatment related to an injury, the Department of Social Services (DSS) has a statutory right to recover those costs from any third-party recovery, including personal injury settlements or judgments. This right creates a lien against your recovery. See Conn. Gen. Stat. § 17b-90 (Assignment of rights; recovery of payments; liens on judgments).
2. How Does DSS File and Enforce a Lien?
- DSS will review your file to determine the total Medicaid payments related to the injury.
- DSS sends you and your attorney a notice of lien with the amount it intends to recover.
- DSS may file a formal lien statement in the Superior Court where the lawsuit is pending.
- Once you resolve your case, DSS submits a claim against your settlement before you disburse funds.
3. Calculating the Lien Amount
The lien typically equals the total medical benefits Medicaid paid for treatment of your injury. You or your attorney should:
- Obtain a detailed breakdown of all Medicaid payments from DSS.
- Verify that each billed service relates directly to the injury claimed.
- Dispute any payments not connected to the injury.
4. Reducing or Waiving the Lien
Under Connecticut law, you can request a waiver or reduction of the lien if repayment would cause undue hardship. Conn. Gen. Stat. § 17b-93 (Recovery procedures; hardship waiver).
- Provide DSS with financial records showing net recovery after attorney’s fees and costs.
- Demonstrate hardship, such as lack of other assets or creditors with higher priority.
- Submit a written waiver request early in settlement talks.
- Negotiate with DSS to reach a reduced pay-back amount.
5. Settlement Approval and Disbursement
- Include DSS in settlement negotiations and copy them on proposed agreements.
- Obtain a final lien letter confirming the amount DSS will accept.
- Set aside funds in escrow or court registry if DSS does not promptly release its lien.
- Distribute remaining settlement proceeds after payment to DSS, attorney fees, costs, and client net recovery.
Helpful Hints
- Track all medical bills and Medicaid payments related to your injury.
- Notify DSS early—don’t wait until after settlement to address the lien.
- Keep detailed financial records if you plan to request a hardship waiver.
- Consider negotiating a lump‐sum compromise rather than full reimbursement.
- Work with an experienced personal injury attorney familiar with Medicaid lien procedures.