Looming Medicaid change means some personal injury claimants may get nothing

Charlotte Personal Injury Attorney Matthew R. Arnold of Arnold & Smith, PLLC answers the question “What can you sue for in a personal injury case?”


If you think the courts are overflowing with personal injury lawsuits, you had better close your eyes for the next year-and-a-half. A looming Medicaid law revision is going to engender a flurry of personal injury lawsuits and settlements, according to an attorney in one of the most litigious counties in the United States.

Taking medicine Charlotte Accident Lawyer North Carolina Injury AccidentBeginning in October 2016, all personal injury settlements in the United States will first be subject to a payback of medical expenses paid by Medicaid.

Edwardsville, Illinois-based attorney Todd Sivia said the change may result in claimants whose medical care was provided by Medicaid having to repay the entire amount advanced by the agency for medical treatment, even if that amount swallows up an entire lawsuit settlement.

Claimants do not have to repay amounts above and beyond a settlement if the settlement cannot cover all of the medical expenses incurred.

The change was passed with a late 2013 federal budget agreement, but its implementation was stalled until October 2016.

Following passage of the rules change, advocates from the Academy of Special Needs Planners said the upshot was that “people who [were] injured by, for example, medical malpractice or negligent drivers could get to keep little or nothing they gain from a lawsuit.”

The Academy explained that the rules change constituted a congressional response to a series of Supreme Court cases that upheld anti-lien statutes. These statutes protect the rights of claimants in lawsuit settlements.

Under existing legislation, if a claimant settles a case for $100,000 and has incurred $50,000 in medical bills, only $25,000 of the settlement funds can be applied to pay the bills. Under the new rules, the total amount—or $50,000—would have to be repaid.

Personal injury attorneys have long had to contend with Medicare liens in personal injury settlements. In general, Medicare liens are only applicable in cases involving older clients. One of the more vexatious problems facing attorneys who settle personal injury cases is estimating the amount of funds to set aside out of a settlement to pay for future medical care. This is a problem that will expand to a new class of clients if the Medicaid rules changes go into effect, Sivia said.

What this means in practical terms to an attorney like Sivia is that plaintiffs and plaintiffs’ attorneys alike will be rushing to get their personal injury lawsuits filed and settled before the rules change goes into effect.

Sivia recounted to the Madison-St. Clair Record how he feared a similar rules change affecting Medicare would affect the settlement of a particular client, who happened to be a Medicare recipient. He was able to resolve the claim before the change went into effect, a process plaintiffs’ attorneys may be repeating ad infinitum in the coming months.

If you or someone you know has any questions regarding potential personal injury claims, feel free to contact the experienced personal injury attorneys at Arnold & Smith, PLLC in Charlotte, North Carolina for a free consultation. Call toll free at (955) 370-2828 or click here for additional resources.



About the Author

ARNOLD & SMITH LAW Matthew Arnold is a Managing Member of Arnold & Smith, PLLC, where he focuses on the areas of family law, divorce, child custody, child support, alimony and equitable distribution.

Mr. Arnold was raised in Charlotte, where he graduated from Providence Senior High School. He attended Belmont Abbey College, where he graduated cum laude, before attending law school at the University of North Carolina at Chapel Hill on a full academic scholarship.

A board-certified specialist in the practice of Family Law, Mr. Arnold is admitted to practice in all state courts in North Carolina, in the United States Federal Court for the Western District of North Carolina, in the North Carolina Court of Appeals and Supreme Court, and in the Fourth Circuit United States Court of Appeals in Richmond, Virginia.

In his free time, Mr. Arnold enjoys golfing and spending time with his wife and three children.









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