California Welfare and Institutions Code 14124.791 – (a) Subject to the director’s prior right of recovery, a …
(a) Subject to the director’s prior right of recovery, a provider who has rendered services to a beneficiary because of an injury for which a third party is liable and who has received payment under the Medi-Cal program shall be entitled to file a lien for all fees for services provided to the beneficiary against any judgment, award, or settlement obtained by the beneficiary or the director against that third party. A provider may only recover upon the lien if the provider has made a full reimbursement of any fees paid by the department for those services.
(b) If either the beneficiary or the director brings an action or claim against the third party, the party bringing the action shall, within 30 days of bringing the action, give written notice to any provider who is eligible to file a lien under subdivision (a) of the action and of the name of the court or state or local agency in which the action or claim is brought. Notice shall be given by personal service or registered mail, and proof of service shall be filed in the action or claim.
Terms Used In California Welfare and Institutions Code 14124.791
- Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
- Beneficiary: means any person who has received benefits or will be provided benefits under this chapter because of an injury for which another person or party may be liable. See California Welfare and Institutions Code 14124.70
- department: means the State Department of Health Services. See California Welfare and Institutions Code 14062
- Lien: A claim against real or personal property in satisfaction of a debt.
- Lien: means the director's claim for recovery, from a beneficiary's tort action or claim, of the reasonable value of benefits provided on behalf of the beneficiary. See California Welfare and Institutions Code 14124.70
- Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
- Medi-Cal: means the California Medical Assistance Program. See California Welfare and Institutions Code 14063
- Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
(c) The provider’s claim for reimbursement for fees for services rendered to the beneficiary shall be limited to the amount of the fees less 25 percent, which represents the provider’s reasonable share of attorneys’ fees for prosecution of the action and of the cost of litigation expense.
(d) No claim authorized by this section shall be permitted to the extent that the claim would reduce the director’s right to recover pursuant to Section 14124.78.
(Amended by Stats. 1992, Ch. 722, Sec. 108.7. Effective September 15, 1992.)