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Under Welfare and Institutions Code section 14124.72, Medi-Cal's reimbursement consists of the benefits it has paid minus 25% for attorney's fees and a pro rata share of the litigation costs. However, pursuant to section 14124.78, Medi-Cal cannot recover more than the plaintiff's net recovery.
A personal injury settlement will not cause a cancellation or have any other adverse effects on an injured party's Medi-Cal coverage. Rather, the program is structured like all other health insurance such that an injured accident victim will not recover double benefits for the same injuries.
For example, if someone is injured in a car accident and their medical insurance pays for the cost of all of their treatment after deductibles, the health insurance company can put a lien against the settlement.
What is a Medical Lien or Hospital Lien? Medical and hospital liens are legally binding contracts between patients and their healthcare provider, such as the hospital or doctor. The lien agreement stipulates that the provider must offer medical treatment to the patient. How a California Medical Lien Affects Your Personal Injury Settlement shirvanianlawfirm.com ? personal-injury ? c... shirvanianlawfirm.com ? personal-injury ? c...
?? If the injured party is Medi-Cal eligible, DHCS will send a "Notice of Lien" asserting its recovery rights within 30 days of the referral. If the injured party is not currently Medi-Cal eligible, DHCS may send notification stating the Medi-Cal status will be rechecked for retroactive eligibility in 90 days.