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Nursing Homes Abuse Blog By Jonathan Rosenfeld

Is Medicare Entitled To Receive A Portion Of My Settlement From A Nursing Home Case?

Posted in Frequently Asked Questions, Medicare

Yes.  In nursing home negligence cases, if Medicare and/or Medicaid paid any medical expenses on your behalf, the agencies are entitled to be reimbursed. Federal laws impose a Medicare and/or Medicaid lien on all injury-related cases involving a recovery from a third-party.

Because many nursing home residents are recipients of Medicare and/or Medicaid, it is important to understand that these agencies have an automatic right to get reimbursed from a recovery from a third-party (any party that may have caused the injury).  Lawyers who handle nursing home negligence cases should be able to help determine what benefits Medicare / Medicaid paid on your behalf.  Moreover, lawyers handling nursing home negligence cases should give you an exact figure as to how much money Medicare and/or Medicaid is receiving from a recovery.

Resource

Third Party Liability in the Medicaid Program

  • Gale

    I understand that Medicare and Medicaid are entitled to a portion of a personal injury case settlement in a nursing home case. I am wondering if Medicare and Medicaid are so interested in recovering the money they have invested why don’t they file their own law suit against the nursing home. Why do they feel that it is right to piggy back upon the victimized residents law suit and collect a portion of their settlement. It is ironic the very govermental agencies which set and support the standards for nursing home care will be the ones to reap the benefits of a law suit filed for abusive behavior by the victimized resident. If a resident in a nursing home is abused and severley injured any law suit settlement should go to that person and, should not become a resource for medicaid. After all it is the resident who is suppose to be compensated for their pain and suffering. The resident is the one who has to endure the disfigurment, loss of mobility and loss of quality of life due to the injury by unskilled and uncaring individuals employed by the nursing home.The money these individuals receive from a law suit should be theirs to do with as they please. After all it’s not money which was generated from an inheritance, selling of property or winning the lottery. this money has been rewarded to the injured resident as a compensation for them being the victim of an awful event. When Medicare and Medicaid reap the benefits of the settlement it sends the message that they are are really not concerned about the actions of the nursing home. Because in order to really make a difference in behavior they also need to file a law suit in order to show the nursing home that no level of abuse will be tolerated. I understand that Medicare and Medicaid pay out thousands for the care of an elderly person in a nursing home but there is no justice for the injured individual if all of the settlement funds have to be payed back to the very system that allowed for a nursing home to deliver sub standard care. If Medicare and Medicaid really wanted to make a difference in the quality of care for the elderly they would file their own law suit and really put pressure on these facilities to preform with higher standards of care. Besides if the system is not changed families of abused individuals will not file law suits and no one will be to the wiser of the continued abuse that goes on in nursing home facilities. Some day it is likely that we who are in our 50′s,60,and 70′s will end up in one of these facilities. And the substandard care will prevail.

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