Medi-Cal Liens Quiz

Provide notification of injury to the Department of Health Care Services (DHCS) within 30 days of filing an action or claim. Inform DHCS when the beneficiary has completed treatment with a Medi-Cal provider or after the settlement has occurred. DHCS will then review the payment records to create a lien, which is a list of injury-related services subject to collection. Finally, you'll need to pay the Medi-Cal lien, ensuring to include the beneficiary's DHCS account number to ensure payment is applied to the correct case.

Under federal and state law, Medi-Cal has a direct right of recovery and is entitled to reimbursement from a liable third party or their insurer for any medical expenses paid on behalf of the beneficiary.

Yes, Medicare can place a lien on a personal injury settlement or award in order to recover the costs of medical care provided as a result of the injury.

The Medicare Secondary Payer law states that Medicare is considered a secondary payer when another entity, such as a liable third party or their insurer, has a primary responsibility for paying a beneficiary's medical costs.

The steps involved in handling a Medicare lien include obtaining Medicare information from the client, contacting Medicare's Benefits Coordination and Recovery Contractor (BCRC), looking for a Rights and Responsibilities letter from the Medicare Secondary Payor Recovery Center (MSPRC), submitting proof of representation to MSPRC, reviewing the Conditional Payment Letter, and monitoring the case with MSPRC.

A Conditional Payment Letter is a letter that Medicare sends within 65 days after receiving proof of representation. It provides a list of all the payments that Medicare will seek reimbursement for.

30 days

After the beneficiary has completed treatment with a Medi-Cal provider

To recover the costs of medical care provided to a Medi-Cal beneficiary as a result of the injury

When another entity has a primary responsibility for paying a beneficiary's medical costs

To provide necessary beneficiary, case, and representative information

To request MSPRC to remove any unrelated claims

To protect the financial interests of entities that have provided services or funds without immediate compensation

The process of placing a lien on a personal injury settlement or award

Health insurance companies, health care providers, and attorneys

Liens can guarantee a full payment of the settlement or award

They can help navigate the complex legal rules surrounding liens

Laws that limit the ability of insurance companies to recover their full payment amount from a settlement or award if the client is not fully compensated for their injuries

It ensures that non-governmental liens are enforceable

Both statutory and contractual

The lien is not legally enforceable

To initiate the process for creating a lien

To notify the MSPRC about the injury

Significant delays in the final resolution of the injury claim

To protect the financial interests of entities that have provided services or funds without immediate compensation

The plaintiff may be able to negotiate a resolution with the lienholder

The negotiations will be smoother and potentially lead to a more favorable outcome for the plaintiff

Through phone calls, emails, and letters

All of the above

It allows insurance companies to recover the costs they have paid for their insured's medical treatment.

They provide a way for clients to handle medical bills and other costs related to their injuries while their personal injury claim is pending.

It can often result in a reduction of the lien amount.

They can negotiate with lienholders to reduce the amount of the lien.