Yes. Under Louisiana practice, medical providers (including chiropractors) and health insurers commonly seek to be paid from a personal injury settlement. Those claims can come in the form of a statutory lien, a contractual lien or a subrogation/recoupment demand from an insurer (including Medicare or Medicaid). Whether and how much is deducted depends on the type of lien, who paid the bills, and whether the lien is negotiated or litigated before distribution of settlement funds.

Detailed answer — how medical and chiropractor claims affect settlement money in Louisiana

Types of claims that can reduce your settlement

• Provider asserted lien or privilege: Some providers may have a statutory or common-law right to claim a portion of recovery related to the injury. In Louisiana, providers often try to secure payment by asserting a lien on proceeds the injured person recovers from a third party. The exact mechanism depends on the provider type and the facts.
• Health insurer subrogation or reimbursement: If private insurance, Medicare, or Medicaid paid medical bills, the insurer may have a right to be reimbursed from the settlement. Federal law gives Medicare a right to recover conditional payments (42 U.S.C. §1395y(b)); Medicaid and private insurers usually have contractual or statutory reimbursement rights.
• Unpaid bills without a filed lien: Even if a provider has not filed a lien, they can still send bills and demand payment from settlement proceeds. Your attorney or settlement administrator often handles these demands before you get paid.

Who gets paid first?

Order of payment typically follows this pattern (but can vary):

1. Settlement-related costs (filing fees, expert fees) may be reimbursed depending on agreement with your attorney.
2. Your attorney’s contingency fee is usually paid from the settlement. Whether the fee is calculated on the gross settlement or the net after liens depends on the contingency agreement and Louisiana law governing attorney fees in personal injury matters.
3. Valid liens, subrogation claims, and statutory reimbursement obligations (e.g., Medicaid/Medicare) are then addressed. Some lienholders must be paid from the settlement; others may be negotiated down or released.
4. The injured party receives the remainder.

Medicare and Medicaid specifically

Medicare has a statutory right to recover conditional payments and will seek reimbursement from any settlement that compensates for the injury. See federal law on Medicare Secondary Payer: 42 U.S.C. §1395y(b). Medicaid programs also expect reimbursement or may assert a claim against settlement proceeds under state law.

What about private medical providers and chiropractors?

Private medical providers (including chiropractors) typically have two options:

• Seek payment informally by sending bills and demanding a share of the recovery.
• File a lien or take legal action to enforce payment. The provider’s ability to file a statutory lien or privilege varies by provider type and local rules. Even without a formal lien, providers can sue to collect unpaid bills, and a judgment can attach to your settlement proceeds.

Negotiation is common and often effective

Most liens and medical bills get negotiated down before funds are released. Providers frequently accept discounts—especially when they know payment can only come from the limited settlement proceeds. Your attorney typically handles these negotiations to maximize your net recovery.

If a lien is disputed

If you dispute a lien’s validity or amount, you or your attorney can litigate the claim. Sometimes the settlement process includes escrow or court approval to resolve disputes before distribution. For minors or settlements requiring judicial approval, the court will ensure lien resolution before final disbursement.

Practical steps you should take

1. Get an itemized statement of all medical charges and what insurance paid.
2. Ask each provider whether they have filed a lien, recorded a privilege, or plan to seek reimbursement from any recovery.
3. Identify any health insurers or public programs (Medicare/Medicaid) that might have subrogation claims.
4. Tell your personal injury attorney about all medical providers and health coverage involved. An attorney can demand written lien releases or negotiate reductions.
5. Do not sign settlement documents or accept funds until all lien issues are addressed. Receiving funds before resolving liens can create personal liability for unpaid providers or insurers.

Hypothetical example (illustrative)

Imagine you recover $100,000 from a car-accident claim. Your attorney’s contingency fee is 33% ($33,000). Medical bills total $20,000 from a chiropractor and $15,000 from an emergency provider. Your private insurer paid $10,000 and says it is owed $10,000 back. Medicare paid $5,000 and asserts a conditional payment seeking repayment.

In practice, your attorney will try to negotiate the $35,000 in bills—often obtaining reductions (for example, settling with providers for $12,000 total). Your private insurer and Medicare may also seek reimbursement but sometimes allow settlements to be apportioned. After negotiated reductions and payment of attorneys’ fees, your net recovery is what remains. The exact amounts depend on negotiations and the legal priority of each claim.

Where to look for Louisiana laws and more information

Louisiana statutes, administrative rules, and court decisions control lien and reimbursement rights in certain situations. For state statute research, you can use the Louisiana Legislature’s site: https://legis.la.gov/. For federal Medicare recovery law, see: 42 U.S.C. §1395y(b).

Helpful Hints

• Do not assume unpaid bills vanish after settlement. Confirm lien status with each provider.
• Ask your attorney for written confirmation of any negotiated lien reductions or releases.
• Provide full insurance information to your attorney so they can handle subrogation demands.
• If Medicare or Medicaid may have paid, notify them early. Medicare requires timely reporting and repayment coordination.
• Keep copies of all medical records, bills, and communications with providers; those help in lien negotiations.
• If you lack a lawyer, consider a consultation before signing any release or taking funds.