Medicaid Third Party Liability Compliance (TPL)

Medicaid requires reimbursement from beneficiaries that settle, receive a judgment or an award related to their workers’ compensation, no-fault or liability case for related treatment that was paid by the state Medicaid program.  Typically, defendants (primary plans) are not responsible to reimburse Medicaid plans for liens, but there are exceptions and it varies by state.  A handful of states require defendants to take certain actions at time of settlement, judgment, award with a beneficiary to properly discharge their liability for any potential liens.

Franco Signor is the only Medicaid Compliance vendor with proven strategies to effectively manage the obligations owed in certain states by defendants.  We have proprietary systems in place to assist with:

  • The identification of claimant’s Medicaid beneficiary status;
  • Lien identification; and
  • Lien disputes to adjust for relatedness and reduction for the beneficiary’s negligence.

Click here for the most current map to show which states defendants have Medicaid Third Party Liability (TPL) obligations.  Please note the recent repeal of Murray Ryan does not impact state rights to recover Medicaid liens under state Third Party Liability (TPL) laws; only that such recoveries must be proportionate to the medical portion of the settlement established for the workers’ compensation, no-fault or liability claim.

Contact us for assistance in establishing best practices for the states you operate in, identifying Medicaid liens, negotiating reductions and getting final lien resolution.

For more information about this service, engage us today at: engage@francosignor.com

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