Medicaid Reimbursement

If you have additional questions, feel free to visit our website at www.lawmed.com, and don't forget to look at some of our other videos at / hensonfuerst
If you have Medicare, Medicaid, Federal Employees Health Insurance, VA Benefits, or other government insurance agencies, then you need to watch this video. Government agencies require repayment of some or all of the money they lay out for your health care after a personal injury. When your settlement dollars come in, you need to consult a lawyer to figure how exactly how much you owe to each agency. This is a complex issue that you can't afford to tackle on your own--the government will find a way to get paid back...or punish you for nonpayment.
** Principal Office of Henson & Fuerst, PA: 2501 Blue Ridge Road, Raleigh, NC 27607 **
Hi, this is David Henson with HensonFuerst. In other videos, I've talked about liens and subrogation interests, which all involve someone else trying to get their hands on your settlement proceeds after your case is resolved. If you missed those videos, then you might want to go back and watch them, as well. Liens, subrogation interests, and reimbursement rights are all related. The common denominator is YOUR MONEY.
Today, I want to talk about those government agencies that also want to get their hands on some or all of your settlement proceeds. This video is for anyone with Medicaid or Medicare or any other government health insurance program. If you don't take advantage of any of those benefits, then feel free to click STOP and go to one of our other educational videos.
If you have Medicare or Medicaid, however, you need to know that they have a statutory right-which means a CLEAR, LEGAL right-to get repaid out of your settlement...for ANY amount they paid on your behalf.
Now for the complicated part: Each of these agencies gets paid back in different ways, sometimes with very different sets of rules. Here is some basic information though:
MEDICARE. Since it is a federal program, MEDICARE gets paid FIRST out of the settlement. As a general rule, MEDICARE must reduce their lien by 1/3 for attorney fees , but otherwise they have the right to full repayment. If you have a very large settlement and only a small MEDICARE lien, then this will be easy to resolve. However, if you have a small settlement, but a very large MEDICARE lien, then you can have a real problem on your hands. MEDICARE can gobble up ALL of your settlement proceeds before anything else is paid. Unfortunately, we run into this situation regularly. In an attempt to reduce the amount repaid to MEDICARE, quite often we have to resort to certain appeals for a waiver or reduction of the lien.
MEDICAID in NORTH CAROLINA has a different set of rules. They get in line behind MEDICARE in order of priority. If you have MEDICAID, then, as a general rule, they get treated the same as a "valid lien holder." This means that North Carolina Medicaid, together with the other valid lien holders, cannot get more than approximately1/3 of the settlement proceeds, no matter what amount they paid in your case.
Some of you may have both MEDICARE and NORTH CAROLINA MEDICAID, in which case the situation can get exponentially more complicated depending on the amounts paid by these agencies, the amount of settlement of your case and the amount of outstanding bills. Unless there is plenty of money from the settlement to pay all of these agencies back, then I strongly encourage you to talk with legal counsel to get some assistance. You absolutely want to make sure that you pay these agencies back correctly, one because they can stop future benefits if you don't, and two since they are the government, they have the ability to come after you civilly or even criminally under the law if you stiff them.
We have focused today on the two major government health insurance plans of Medicare and Medicaid. If you have one of the other government health insurance plans such as Federal Employee's health insurance plan, Tricare or Champus, or VA benefits, then shoot me an email at [e-mail] and let me know to do a future shoot on one of those agencies if you would like more information.
No matter the kind of insurance, if your case involves ANY government health insurance-MEDICARE, Medicaid, TriCare/Champus, or VA benefits-then you need to proceed carefully with the settlement and resolution of your case. You should know in advance that these agencies will be standing with their HANDS OUT when your case is resolved. It is critically important that you and your lawyer follow the laws, and when possible, attempt to reduce or minimize the amounts that must be paid back.
This is David Henson with HensonFuerst. If you have additional questions, please go to our website at www.lawmed.com. If you have questions, HensonFuerst have answers.

[@blessedbeyond5628]

Even if i made payments with Medicaid after a personal injury case...can I request to recieve all my money from the insursnce company and pay the medical providers or medicaid on my own?

[@sherrodhenderson521]

Where are u at David?

[@sherrodhenderson521]

When can we talk