Attorneys involved in a settlement, judgment, or other award must be aware that Federal and/or State Medicaid may have a right to reimbursement from those proceeds. State Medicaid Agencies are becoming more aggressive. On July 17, 2015, the Mississippi Division of Medicaid (“DOM”) issued correspondence to every member of the Mississippi Bar. The correspondence noted that “[b]oth federal and state law mandate DOM to recoup 100% of the amount of medical assistance provided to a beneficiary when a third party payer is available.” The correspondence further discusses the changes to Mississippi Code Ann. Section 43-13-125 that removes the Court’s authority to determine the amount DOM is entitled to recover. As typical, attorneys are still authorized to recover reasonable fees and expenses prior to DOM’s requested reimbursement. Finally, the correspondence notes the recent case of Mississippi Division of Medicaid v. Pittman, No. 2014-SA-00765-COA (June 30, 2015), which held that the “made whole” doctrine does not apply to negate the DOM’s subrogation claim in instances where beneficiaries are not fully compensated for their injuries.
As with any Medicaid lien, it is important to have an experienced attorney notify Medicaid of the lawsuit and then review and negotiate the lien.