Does Medicare always have to be paid back from a settlement?

Yes. If Medicare made conditional payments related to your injury, reimbursement is legally required. There is no mechanism to simply waive Medicare's right of recovery, though the amount owed can often be significantly reduced through negotiation.

What happens if I don't pay the Medicare lien?

If the Medicare lien is not satisfied, CMS can pursue the full amount plus interest directly from you, your attorney, or anyone who received settlement funds. CMS can even pursue double damages in some circumstances. This is not a lien that can be ignored.

Does Medicaid have to be paid back if I am on Florida Medicaid?

Yes. Florida Medicaid's right to reimbursement is established by both federal law and Florida Statute 409.910. The amount is typically calculated using a statutory formula, though it can be challenged if the formula produces an excessive result.

Can my attorney negotiate the lien without my involvement?

Yes. Lien negotiation is handled entirely by your attorney on your behalf. However, you should be kept informed of the lien amount and any negotiations, since your final net recovery depends on what remains after the lien is satisfied.

Will the lien affect how much I receive from my settlement?

Yes. Your net recovery from a settlement is what remains after attorney's fees, litigation costs, and any Medicare or Medicaid liens are satisfied.

How long does it take to resolve a Medicare or Medicaid lien?

Timelines vary greatly. CMS (Medicare) can take weeks to months to issue a final demand letter after notification of settlement. Florida Medicaid (AHCA) typically responds more quickly. Your attorney should begin the lien resolution process as early as possible to avoid delays in distributing your funds.