Department of Health Care Services’ Right to Reimbursement of Medical Expenses Covered on Behalf of a Medi-Cal

When a plaintiff asserting a bodily injury claim against a third party has had medical treatment expenses relating to the injury covered by Medi-Cal, the Department of Health Care Services (“DHCS”) generally has a right to reimbursement of these costs.

Under these circumstances, DHCS will assert a lien against any settlement, judgment, or award obtained from a liable third party for health care services that Medi-Cal covered on behalf of the Medi-Cal member relating to the injury. (WIC § 14124.71). The plaintiff must resolve this lien before he or she can obtain disbursement from any settlement, judgment, or award that has been recovered.

The lien asserted by DHCS is limited to the portion of the settlement, judgment, or award that represents payment for medical expenses or care covered by DHCS. (WIC § 14124.76).

DHCS has the authority to compromise, settle, or waive any claim to recovery under this Section. (WIC § 14124.71). Thus, if DHCS has asserted a lien for reimbursement on your bodily injury settlement, seeking the advice of legal counsel can assist in negotiating this lien in order to increase your total recovery award.

If you need assistance with a lien asserted by DHCS on your bodily injury recovery or you have any questions, please our office at 626-577-7700.


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