It may come as an unwelcome shock to many personal injury plaintiffs, but Medicaid is entitled to recover medical expenses paid on behalf of an individual, from the proceeds of a personal injury or a malpractice action.
The entire award is subject to Medicaid recovery: there is no distinction between pain and suffering and medical expenses, both portions of the award are subject to Medicaid liens. Unlike estate claims, there is no limitation on the age of the recipient for Medicaid to impose its lien.
The lien is limited to Medicaid payments made after the date the injuries were sustained. The lien is also limited to those Medicaid payments made for the treatment of injuries sustained. The rationale is that Medicaid is not entitled to recover for Medicaid properly paid (other than from estate claims).
One final limitation is that Medicaid is not entitled to a recovery when the claim is against a nursing home based on negligence or abuse of a Medicaid patient.
Medicaid lien has the priority over all other liens, with the exception of the attorney fee for representing the injured party in an action to recover for the injuries in the accident. However, the attorney is not entitled to a fee from the proceeds being paid to Medicaid.
Disclaimer: This article only offers general information. Each situation is unique. It is always helpful to talk to a specialized attorney, to figure out your various options and ramifications of actions. As every case has subtle differences, please do not use this article for legal advice. Only a signed engagement letter will create an attorney-client relationship.