Medicare and Medicaid Liens on a New York Injury Settlement

By the FigureMyTax Editorial Team · How we calculate

New York public assistance officials have a lien on a recipient's injury claim up to the assistance furnished, effective on written notice before payment and subordinate to your attorney's lien. We did not confirm how it applies to Medicaid medical assistance. Medicare recovers under federal rules.

The public assistance lien

Social Services Law 104-b says that if a recipient of public assistance and care has a claim for personal injuries, the public welfare official has a lien for an amount it fixes, up to the total assistance furnished from the injury date. It is effective only if a written notice with the recipient's name, the accident date and place, the person liable and the amount claimed is served by certified or registered mail before any payment, and a copy goes to the liability insurer.

Payer duties and priority

A person or insurer intending to pay must notify the official at least 10 days before the payment, or becomes liable as if notice had been given. No release is valid against the lien. The lien is subordinate to your attorney's lien and, for certain treatment, to a hospital lien under the lien law.

What we did not confirm

Whether and how the state applies this section to Medicaid medical assistance, which is a separate program, we did not confirm. A related section limits liens against an individual's property on account of medical assistance (Social Services Law 369), but we read it as addressing property, not third-party injury claims. Ask an attorney and request an itemization and a written reduction.

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 hospital liens work and why most health plans are barred in New York, then enter every claim in the New York medical lien calculator.

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