This blog discusses N.J.’s statutory lien laws to recover medical and other expenses paid to accident and other victims by N.J. Medicaid- N.J. pays significant costs for medical expenses incurred by uninsured or under insured victims of personal injury, accidents and other causes
- Federal law allows N.J. to impose a statutory lien on settlement amounts and damage claims paid by third parties
The Medicaid Act requires participating States, like N.J. to pay for the medical costs of eligible individuals and then to make reasonable efforts to recoup these costs from liable third parties. 42 U.S.C. §1396k(a)(1)(A). Under N.J.s Medicaid Third-Party Liability Act, a beneficiary who “accept[s] medical assistance” from Medicaid “automatically assigns to the [state] agency any right” to receive third-party payments for medical care. N.J.’s statutory framework entitles the State to file a lien against any money received by the beneficiary that is for “past and future medical expenses.”
In a recent case a Medicaid beneficiary brought a lawsuit seeking to block a law similar to N.J.’s that allowed the state to recover money paid to accident victims in compensating for future medical expenses. The federal appeals court concluded that the relevant provisions of the law do not prevent a State from seeking reimbursement from settlement monies allocated for future medical care.
In this case the injured victim argued that the Medicaid Act’s anti-lien provision prohibits States from recovering medical payments from a beneficiary’s “property.” She claimed the federal law forecloses recovery from settlement amounts other than those allocated for past medical care paid for by Medicaid. But the Court held that state laws expressly authorize that they be reimbursed for paid-out medical expenses. “Payment for medical care,” past or future – “is expressly authorized by the terms of federal law.” The Medicaid Act requires that state plans include “mandatory assignment of rights of payment for medical support and other medical care owed to recipients.” The federal law does not distinguish between past (paid) medical care payments and future (unpaid) medical care payments. If Congress had intended to draw such a distinction, “it easily could have drafted language to that effect” said the Court.
To discuss NJ Medicaid and/or Special Needs Trust, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com. Please ask us about our video conferencing or telephone consultations if you are unable to come to our office.
By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold Township, Monmouth County, NJ Special Needs Trust Attorney