Medicare and Medicaid Liens on a Mississippi Injury Settlement

By the FigureMyTax Editorial Team · How we calculate

Mississippi Medicaid takes an assignment of your rights to the extent of what it paid. A recovery is applied first to collection costs and attorney fees, then to Medicaid's interest, and any excess goes to you. You must notify the division when you sue, and it must be paid within 60 days of a settlement. Medicare recovers under federal rules.

The assignment

Miss. Code 43-13-305(1) says that by accepting Medicaid the recipient is deemed to assign to the division all rights in any third-party benefits or cause of action for benefits it provided, and appoints the division as attorney-in-fact to collect them, without signing anything.

The order of payment

Section 43-13-125(2) says any amount recovered is applied first to the reasonable costs of collection, including attorney's fees approved by the court, or in a settlement without suit by the division's legal representative; then to Medicaid's interest, or an amount agreed between the division's lawyer and yours; and any excess is awarded to you.

Notice and timing

You or your lawyer have an absolute duty to notify the division when you start legal proceedings, with a copy of the pleadings certified to it, and the third party and its insurer have an absolute duty to notify it of a proposed compromise. Payments must be remitted within 60 days of a settlement or final judgment, or the division may assert its rights plus interest. A compromise without advance notice is conclusive evidence of the third party's liability in the division's later action, and no compromise binds the division unless it approved it in writing.

Compromise

The division, with the Governor's approval, may compromise or release its claim at its sole discretion and is not required to do so.

Federal limit and Medicare

In Arkansas Department of Health and Human Services v. Ahlborn (2006), the U.S. Supreme Court held that Medicaid may reach only the portion of a settlement that represents medical costs. Under the Medicare Secondary Payer statute, 42 U.S.C. 1395y(b)(2), the United States may recover conditional payments and collect double damages from responsible entities; 42 CFR 411.24 governs recovery, and 42 CFR 411.37(c) reduces Medicare's recovery by its procurement-cost share. On a $100,000 settlement with $36,333 of fees and costs, $15,000 of Medicare payments would shrink to about $9,550.

Next steps

See how provider bills work and what Mississippi courts say about health plan reimbursement, then enter every claim in the Mississippi medical lien calculator.

This is general information, not legal advice, and the state comparisons above are illustrative, not an exhaustive survey. Confirm how Mississippi's rules apply to your specific case with a licensed Mississippi attorney.