Addressing Medi-Cal liens in auto accident cases in California involves several steps to ensure that the client’s interests are protected while complying with legal obligations. Here’s how attorneys typically handle Medi-Cal liens:
- Identification of Medi-Cal Lien: The attorney first identifies whether the client received medical treatment covered by Medi-Cal as a result of injuries sustained in the auto accident. This is often evident from medical bills and records provided by the client.
- Verification of the Lien Amount: The attorney requests a lien reimbursement statement from the California Department of Health Care Services (DHCS), which administers Medi-Cal. This statement outlines the amount of the Medi-Cal lien, including any interest accrued.
- Review of the Lien Statement: The attorney carefully reviews the lien reimbursement statement to ensure its accuracy and verify that all charges are related to the auto accident injuries. They may request itemized billing records from medical providers to confirm the validity of the charges.
- Negotiation with DHCS: The attorney engages in negotiations with DHCS to seek a reduction in the lien amount. This may involve presenting evidence of comparative fault, arguing for a reduction based on the client’s financial hardship, or disputing the inclusion of certain charges in the lien.
- Resolution of the Medi-Cal Lien: Once a negotiated settlement is reached with DHCS, the attorney obtains a final lien reimbursement statement reflecting the agreed-upon amount. This statement is used to calculate the portion of the settlement or judgment proceeds that must be allocated to satisfy the Medi-Cal lien.
- Allocation of Settlement Proceeds: The attorney ensures that the portion of the settlement or judgment proceeds required to satisfy the Medi-Cal lien is set aside and paid directly to DHCS. This is typically done through a process known as “lien resolution” or “lien reduction,” where DHCS agrees to accept a reduced amount in satisfaction of the lien.
- Disbursement of Remaining Funds: After satisfying the Medi-Cal lien, the attorney disburses the remaining settlement proceeds to the client. This ensures that the client receives a fair recovery after accounting for the lien obligation.
- Compliance with Legal Requirements: Throughout the process, the attorney ensures compliance with all legal requirements related to Medi-Cal liens, including providing proper notice to DHCS, obtaining approval for lien resolution, and documenting the lien resolution process.
By effectively addressing Medi-Cal liens in auto accident cases, attorneys can help their clients maximize their recovery while satisfying their obligations to Medi-Cal. This often requires careful negotiation and attention to detail to achieve a favorable outcome for the client.