MEDICAID LIENS IN VIRGINIA MEDICAL MALPRACTICE CASES

Medicaid.

Heard of it I assume?

Maybe you receive Medicaid?

If you live in Virginia, and are on Medicaid, you have qualified because of low income or you are on disability. Medicaid is an AID (read Medicaid) program that is State funded, to help those Virginians that need health care and cannot afford coverage.

Medicaid is paid for by Virginia tax payers. The hope is that fewer and fewer people will need the benefit, but in reality, more and more families find themselves in need.

Now, what does Medicaid have to do with your Medical Malpractice case? Follow me as we learn about a fictional family.

Mary Smith was born this past May 2010. When she was born, the physicians failed to diagnose Ms. Mary with jaundice, and her billrubin levels were very high. It is possible she will have some delayed learning, but probably Ms. Mary will be just fine, thank God.

Mary’s Mom has Medicaid, which means Mary is also covered by Medicaid.

The original hospital bill – covered by Medicaid.
The second admission, related to the jaundice, covered by Medicaid.
Mary may need a few more treatments, but those will also be covered.

What is Mary’s Mom wanted to sue the hospital for failing to diagnose the jaundice?

We would have to get records ($100 plus).
Hire experts to review records ($1000 plus).
File the lawsuit ($300 plus).
Argue the lawsuit – use more experts – make copies – hire court reporters – get ready for trial – ($10,000 plus)

And then the jury gives Mary a total of $50,000 because thankfully, she will be ok in the end.
40% to the lawfirm
Remaining costs taken out.
Medicaid will place a lien on the case, to be repaid for Medical bills they paid for.

What?

Yes. Lets say the second hospitalization was $7,000 and the additional treatments were $11,000 total – all paid for by the State of Virginia Medicaid fund.

If a jury gives Mary’s family $50,000 this is what will happen:

  $50,000
  – 20,000 (attorneys fees)
  -10,000 (costs for experts etc)
  – 18,000 (Medicaid lien)
________
WAIT 1 MINUTE
$2,000 goes to family – That’s all?

There is nothing left for the family. In fact, Medicaid put a lien on almost all the recovery. And, even if they didn’t, Mary and her family could lose their Medicaid coverage if the money is not properly put into a trust for Mary’s long term needs.

So, since Medicaid will come ask for re-payment, it doesn’t always make sense to file a lawsuit. Sometimes, if your choice is no lawsuit and keep your benefits, or file a lawsuit and risk losing benefits, we advise families not to file suit.

Sometimes – Medicaid liens make it such that we do not recommend filing suit. Sometimes, the lien is too high to warrant the effort.

If you have a Medical Malpractice case, we are happy to evaluate whether it is worth the time to investigate and pursue in light of your potential medical lien. Call us today

Dan Frith

Dan Frith

Dan Frith has over 25 years of experience representing individuals and families in cases of medical malpractice throughout Virginia. He has been named "Best Medical Malpractice Attorney" by Roanoker Magazine and is a member of the Million Dollar Advocates Forum. To speak with Dan, contact him by email at dfrith@frithlawfirm.com.