Medicare and Medicaid Liens on a Nebraska Injury Settlement

By the FigureMyTax Editorial Team · How we calculate

An application for Nebraska medical assistance gives the department a right of subrogation for every claim involving money for medical care, and the third party must pay it directly once notified in writing. The statute has no fee formula, and the department negotiates reductions. Medicare recovers under federal rules.

Subrogation

Neb. Rev. Stat. 68-716 says an application for medical assistance gives the Department of Health and Human Services or its assigns a right of subrogation. Subject to the spousal protections in sections 68-921 to 68-925, subrogation includes every claim or right the applicant may have against a third party when it involves money for medical care. The third party is liable to pay the department directly as soon as it is notified in writing of the valid claim.

No fee formula in the statute

We found no Nebraska section that says attorney fees come off first or that gives the department a fixed share. The department's own forms describe a reduction request with your fee agreement, an itemization of liens and costs, and the proposed distribution, and say it will negotiate when funds are insufficient. The calculator lets you enter the percentage you expect it to accept.

Managed care plans

The department's materials say there may be separate recovery claims from each Medicaid managed care organization. Ask the department and each plan for an itemized claim.

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 liens work and what Nebraska courts say about health plan reimbursement, then enter every claim in the Nebraska medical lien calculator.

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