Understanding Medicaid’s Third-Party Liability in Nevada
In Nevada, when Medicaid pays for medical care related to a personal injury, the Division of Welfare and Supportive Services (DWSS) has a statutory right to recover those costs from any third-party settlement or judgment. This right arises under Nevada Revised Statutes (NRS) 422.396 and NRS 422.398.
Under NRS 422.396, Medicaid is considered a third-party payer. When a beneficiary settles a claim or obtains a judgment against a negligent party, Medicaid may assert a lien for the amount it paid. NRS 422.398 directs the agency to enforce that lien and apply recovered funds to reimburse the Medicaid program.
Steps to Address a Medicaid Lien in Your Settlement
- Identify Medicaid Payments: Review all medical bills paid by Medicaid for treatment of injuries from the accident.
- Notify DWSS Promptly: Under NRS 422.398(5), you must inform the DWSS of any claim or lawsuit within 30 days of filing. This preserves Medicaid’s lien rights.
- Receive a Demand Letter: DWSS will issue a demand for reimbursement outlining the amount it seeks from your settlement.
- Hold Settlement Funds in Escrow: To avoid delays or disputes, place your settlement proceeds in a neutral escrow or court registry pending lien resolution.
- Resolve the Lien: Pay the full lien amount or negotiate a reduced figure. See NRS 422.396(4) for possible reductions when full recovery would cause hardship.
- Distribute Remaining Funds: Once the Medicaid lien is satisfied, you may receive the balance of your settlement.
Negotiating or Reducing the Medicaid Lien
Nevada law allows DWSS to consider waiver or compromise of a lien if enforcement would cause undue hardship to the beneficiary. To request a reduction:
- Submit a written hardship request to DWSS detailing your financial situation.
- Provide documentation of your income, assets, and the total settlement amount.
- Negotiate a payment plan if you cannot pay the lien in a lump sum.
Protecting Your Settlement Funds
Escrow agreements or court-supervised funds ensure DWSS cannot seize amounts beyond its lawful lien. Always obtain a written lien payoff statement before disbursing settlement proceeds.
Disclaimer
This article is for informational purposes only and does not constitute legal advice. Consult a qualified attorney in Nevada for guidance specific to your situation.
Helpful Hints
- Keep detailed records of all medical expenses paid by Medicaid.
- Respond quickly to any notices from DWSS to protect your rights.
- Consider working with an attorney experienced in Medicaid third-party liability.
- Verify lien amounts with DWSS before finalizing any settlement.
- Explore hardship waivers if repayment would create severe financial difficulty.