249A.6 - ASSIGNMENT -- LIEN.
249A.6 ASSIGNMENT -- LIEN.
1. a. As a condition of eligibility for medical assistance, a
recipient who has the legal capacity to execute an assignment shall
do all of the following:
(1) Assign to the department any rights to payments of medical
care from any third party.
(2) Cooperate with the department in obtaining payments described
in subparagraph (1).
(3) Cooperate with the department in identifying and providing
information to assist the department in pursuing any third party who
may be liable to pay for medical care and services available under
the medical assistance program.
b. Any amount collected by the department through an
assignment shall be retained by the department as reimbursement for
medical assistance payments.
c. An assignment under this subsection is in addition to an
assignment of medical support payments under any other law, including
section 252E.11.
2. When payment is made by the department for medical care or
expenses through the medical assistance program on behalf of a
recipient, the department shall have a lien, to the extent of those
payments, upon all monetary claims which the recipient may have
against third parties. A lien under this section is not effective
unless the department files a notice of lien with the clerk of the
district court in the county where the recipient resides and with the
recipient's attorney when the recipient's eligibility for medical
assistance is established. The notice of lien shall be filed before
the third party has concluded a final settlement with the recipient,
the recipient's attorney, or other representative. The third party
shall obtain a written determination from the department concerning
the amount of the lien before a settlement is deemed final for
purposes of this section. A compromise, including but not limited to
a settlement, waiver or release, of a claim under this section does
not defeat the department's lien except pursuant to the written
agreement of the director or the director's designee. A settlement,
award, or judgment structured in any manner not to include medical
expenses or an action brought by a recipient or on behalf of a
recipient which fails to state a claim for recovery of medical
expenses does not defeat the department's lien if there is any
recovery on the recipient's claim.
3. The department shall be given notice of monetary claims
against third parties as follows:
a. Applicants for medical assistance shall notify the
department of any possible claims against third parties upon
submitting the application. Recipients of medical assistance shall
notify the department of any possible claims when those claims arise.
b. A person who provides health care services to a person
receiving assistance through the medical assistance program shall
notify the department whenever the person has reason to believe that
third parties may be liable for payment of the costs of those health
care services.
c. An attorney representing an applicant for or recipient of
assistance on a claim upon which the department has a lien under this
section shall notify the department of the claim of which the
attorney has actual knowledge, prior to filing a claim, commencing an
action or negotiating a settlement offer.
(1) Actual knowledge under this section shall include the notice
to the attorney pursuant to subsection 2.
(2) The mailing and deposit in a United States post office or
public mailing box of the notice, addressed to the department at its
state or district office location, is adequate legal notice of the
claim.
4. The department's lien is valid and binding on an attorney,
insurer, or other third party only upon notice by the department or
unless the attorney, insurer, or third party has actual notice that
the recipient is receiving medical assistance from the department and
only to the extent to which the attorney, insurer, or third party has
not made payment to the recipient or an assignee of the recipient
prior to the notice. Payment of benefits by an insurer or third
party pursuant to the rights of the lienholder in this section
discharges the attorney, insurer, or third party from liability to
the recipient or the recipient's assignee to the extent of the
payment to the department.
5. If a recipient of assistance through the medical assistance
program incurs the obligation to pay attorney fees and court costs
for the purpose of enforcing a monetary claim upon which the
department has a lien under this section, upon the receipt of the
judgment or settlement of the total claim, of which the lien for
medical assistance payments is a part, the court costs and reasonable
attorney fees shall first be deducted from this total judgment or
settlement. One-third of the remaining balance shall then be
deducted and paid to the recipient. From the remaining balance, the
lien of the department shall be paid. Any amount remaining shall be
paid to the recipient. An attorney acting on behalf of a recipient
of medical assistance for the purpose of enforcing a claim upon which
the department has a lien shall not collect from the recipient any
amount as attorney fees which is in excess of the amount which the
attorney customarily would collect on claims not subject to this
section.
6. For purposes of this section the term "third party"
includes an attorney, individual, institution, corporation, or public
or private agency which is or may be liable to pay part or all of the
medical costs incurred as a result of injury, disease, or disability
by or on behalf of an applicant for or recipient of assistance under
the medical assistance program.
7. The department may enforce its lien by a civil action against
any liable third party. Section History: Early Form
[C79, 81, § 249A.6] Section History: Recent Form
83 Acts, ch 120, § 1; 83 Acts, ch 153, § 15; 89 Acts, ch 111, § 1;
93 Acts, ch 180, §50; 94 Acts, ch 1023, §89; 2008 Acts, ch 1014, §2;
2009 Acts, ch 41, §244; 2009 Acts, ch 133, §96