I just got a Medicare “reduction” from OHCA dated 11/18/09 stating that: “Your client would be responsible for the full amount billed were your client not a Medicaid recipient. As the actual medical billings were $ 55,xxx while the OHCA lien is only for $ 14,xxx it appears that your client has received significant benefits from Medicaid.” This quote is from a new form that OHCA is using and only the underlined numbers are changed on the form. (The italics are theirs.) They then agree to reduce to $12,xxx and state that this is good for only 30 days. I thought that the new law mandated a prorate reduction for the attorney fee/expenses like Medicare? Am I wrong? Does it depend on the date of the accident or payments by Medicaid? Or are they refusing to follow the new statute?
Answer: It sounds like they are going to take the position the new statute does not apply to existing lawsuits. Be aware the Oklahoma Health Care Agency has sued in the Supreme Court the Governor, Speaker of the House and President Pro Tem of the Senate for an injunction, arguing the new statute is unconstitutional under the Oklahoma Constitution and in violation of federal law. I filed yesterday an application for leave to file an amicus brief in the Supreme Court. That litigation does not, however, address whether the statute applies to a pending lawsuit.
Posted on Mon, March 22, 2010
by Sharon Coleman filed under