Medicare and Medicaid Liens on an Oregon Injury Settlement

By the FigureMyTax Editorial Team · How we calculate

The Department of Human Services and the Oregon Health Authority have a lien on your judgment or settlement for assistance received since the injury, but it does not attach to your attorney fees, costs and expenses or to the medical expenses you paid yourself. Medicare recovers under federal rules.

The lien

ORS 416.540 gives the agencies a lien on a judgment or settlement for all assistance received from the injury date to the date of satisfaction. Subsection 2 says it does not attach to the extent of attorney fees, costs and expenses incurred in securing the recovery, and to the extent of medical, surgical and hospital expenses the recipient incurred on account of the injuries.

Notice and perfection

If you make a claim, or start an action without making a claim, you or your attorney must immediately notify the agency, and for a minor the parents, guardian or foster parents must (ORS 416.530). To perfect the lien, the agency files a notice with the county recording officer and sends a certified copy by registered or certified mail before the settlement is paid (416.550). The person bound by the settlement must notify the agency immediately, and the agency then states the amount of its lien (416.570).

Minors

For a minor, a guardian or conservator petitions the probate court to determine the sum needed for complete physical rehabilitation, and the lien does not attach to that sum (ORS 416.590).

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 why Oregon bars reimbursement until you are fully compensated after a car accident, then enter every claim in the Oregon medical lien calculator.

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