The health care reform law, the Affordable Care Act (or ACA), is getting into full swing. A component of the law is the expansion of Medicaid, the state run program which provides lower income people with health insurance. Regardless of what you may feel about the politics of the ACA or Medicaid, the reality is that this will significantly affect the practice of personal injury law.
About 5 million New York State residents are currently enrolled in Medicaid. That number is expected to rise dramatically as 2014 continues and the Medicaid expansion gains steam.
The increased availability of Medicaid becomes a mixed blessing for the personal injury victim. On the one hand, increased access to medical care strengthens the personal injury case. The injured person now has access to doctors who can regularly treat, document, and confirm the person’s injuries. The injured person can utilize expensive treatments they couldn’t afford to pay out of pocket, such as surgery and physical therapy. Such treatments are proof of the severity of the injury. And most importantly, the injured person can get the treatment needed to heal.
On the other hand, the accident victim who relies on Medicaid is subject to a lien on their personal injury award. By law, the government is entitled to repayment of what it spent on your medical treatment, if you win money in a personal injury suit. Medicaid will inform your lawyer of the amount owed. This amount must be taken into account when engaging in settlement negotiations. It may become difficult to settle a case if the Medicaid lien is very high, as the lawyer has the responsibility to not only repay Medicaid, but make sure the injury victim walks away with something in their pocket as well. Grappling with the obligations of Medicaid liens will become an increasing part of the practice as the ACA paves the way for Medicaid expansion. We at Tolmage Peskin understand the details about the injury victim’s obligations to Medicaid. We have successfully navigated the Medicaid waters for our clients, and have ensured that they benefit after fulfilling their obligations.
