Disclaimer: This article is for informational purposes only and does not constitute legal advice. Always consult a qualified attorney for advice on your specific situation.
Detailed Answer
When you receive Medicaid benefits in North Dakota, the Department of Human Services (DHS) has the right to recover medical costs from any third-party personal injury settlement you obtain. This right is known as “subrogation” or a lien. To protect your settlement and comply with state law, follow these steps.
1. Identify Medicaid’s Lien Early
Notify the ND DHS Medicaid office as soon as you file a personal injury claim. Under North Dakota Century Code § 50-24.1-17, DHS has a statutory lien on any recovery for services paid by Medicaid. You can view the statute here: NDCC § 50-24.1-17.
2. Request an Itemized Statement
Ask DHS for a detailed breakdown of all medical expenses it paid on your behalf. This statement shows the precise amount of the lien and the dates of service. Having an exact figure helps avoid surprises at settlement.
3. Negotiate the Lien Amount
North Dakota law allows you to request an adjustment to Medicaid’s lien when a contingent-fee attorney represents you. Under federal regulation (42 C.F.R. § 433.154), you can argue for a reduction based on attorneys’ fees and case-related costs. Prepare a written proposal showing:
- Total gross settlement
- Attorney’s fees and litigation expenses
- Net recovery to you
Submit this to DHS and ask for a formal reduction.
4. Include Lien Payment in the Settlement Order
When drafting the settlement agreement or court order, explicitly state that funds will be disbursed to:
• Your attorney’s trust account for fees and your net award
• ND DHS for the lien amount
This ensures DHS is paid directly from the settlement before you receive your portion.
5. Obtain a Release of Lien
After DHS receives payment, request a written release. This document confirms the lien is satisfied and prevents future claims on the same medical expenses.
Helpful Hints
- Track all medical bills paid by Medicaid and keep copies.
- Notify the Medicaid liaison at your attorney’s office early.
- Get the lien amount in writing before settlement negotiations.
- Document your attorney’s fees and case costs for lien reduction arguments.
- Review the settlement agreement to confirm Medicaid payment terms.
- Retain the DHS lien release for your records.