Settling Medi-Cal Liens in Personal Injury Cases

by Sacramento Personal Injury Lawyer Noah Schwinghamer

When someone files a personal injury lawsuit in California, and Medi-Cal has paid for some of the plaintiff’s medical bills, the plaintiff has an obligation to notify Medi-Cal, and possibly pay back the money that Medi-Cal paid.

What is Medi-Cal?

Medi-Cal is California’s Medicaid program.  It provides services to low-income families, seniors, persons with disabilities, children in foster care, pregnant women, and certain low-income adults.

Medi-Cal is run by the DHCS – California Department of Health Care Services (a State program), CMS – the Centers for Medicare & Medicaid Services (a Federal Program), and often administered at the county level.  Confused yet?

What are a Plaintiff’s Obligations When Filing a Personal Injury Lawsuit?

1.  Report the Lawsuit to Department of Health Care Services (DHCS) Within 30 Days of Filing Suit. 

This may be submitted online, via mail, or via fax.

Contact Information

Department of Health Care Services
Third Party Liability and Recovery Division
Personal Injury Unit-MS 4720
P.O. Box 997425
Sacramento, CA 95899-7425
Phone:  916.650.0490
Fax:  916.440.5668

[Link To Submit Forms Online]

[This is required by Welfare and Institutions Code Section 14124.70 et seq.]

2.  Send DHCS a Medical Authorization.

This allows them to communicate with the attorney.

3.  DHCS will send a ‘Notice of Lien’

Medi-Cal claims this can take “up to” 120 days.  In actuality it often seems to take longer.

Medical providers have up to one year from date of service to submit bills to Medi-Cal for payment. Once all related services have been identified, the final lien will be established when the beneficiary has reached a settlement. DHCS has the right to collect for dates of services provided up to the date of settlement.

Phone Numbers to Speak to Medi-Cal:

**Update**

As of at least August 2015, the best way to get in touch with Medi-Cal is to call (916) 445-9891.  This number should lead to a live-person call center.  Callers should wait for the next available representative.


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