WHAT ARE MEDI-CAL LIENS?
We would never want our dear ones to face any injuries which required medical care. Unfortunately, there will be some circumstances where we have to address sudden injuries which happen when someone else causes injury.
In California, the State can help victims by bearing the expenses of medical bills from the state treasury. This program is called Medi-Cal liens which is the state-specific version of the Medicaid program across the USA.
In the situation where your loved one belongs in a lower income group where he/she cannot afford personal health insurance, there couldn’t be a more relevant and helpful program than Medi-Cal.
As the Medi-Cal is being funded from the taxpayers money, the Californian Department of Health Care Services (“DHCS”) reserves the right to recover a certain amount for the expenditure made by the patient if they receive anything out of settlement or from the lawsuit. This arrangement is called Medi-Cal Lien.
If you can reduce the lien number to any extent, it can be significantly beneficial to the injured victim himself.

HOW CAN YOU REDUCE MEDI-CAL LIENS?
The following steps can be used to get the lien amount reduced.
- Notify DHCS
As DHCS reserves the right to recover through lien, there is a responsibility upon you to notify them. This notification would generally be done through their website. DHCS will acknowledge receiving such notification within thirty days with a unique number referring to your case and file.
- Summary of Benefits
Though the DHCS doesn’t provide final lien numbers until you request the final lien number, they would certainly provide the ‘summary of benefits’ which is likely closer to the final estimate that the department could claim for reimbursement which will at least give you a rough ballpark number. This can be requested by the parties or, they can even attempt to go through the bills manually to get an estimated amount.
- Negotiation
The attorney can start negotiations to lower the lien once you have the final Medi-Cal lien amount. The DHCS lien recovery is “limited to that amount of a settlement, judgement, or award that constitutes reimbursement for medical costs or medical services given to the beneficiary.”
A qualified injury lawyer could potentially employ a “Ahlborn Reduction” argument on a client’s injury case to lower any MediCal health lien interest that must be paid back to MediCal at the time of a personal injury settlement. The greater the lawyer’s ability to lower the Medi-Cal lien interest, the more the client could receive as monetary compensation from the settlement.
- Ahlborn Calculation
The formula is Total Settlement Amount / Total Claims Value X Medi-Cal Lien’s. The “Total Value of Claims” is the most significant component here.
It is critical not to confuse this number with the case value. For instance, when there is contributory negligence, the value of a lawsuit may be reduced. The worth of one’s claims, or “overall damages,” as defined by the Supreme Court in the case of Ahlborn, remains unchanged.
- Damages calculation
Increasing the “Total Value of Claims” factor will result in the most Medi-Cal lien deduction. The entire amount of claims in personal injury lawsuits is mostly made up of past and future medical bills as well as consequential damages.
As the past bills might have been paid already, it is important to include all the other bills paid personally and also the future bills that could occur. The doctor’s recommendations, expert suggestions could be included in the bills, if they are going to cost the expenses.
The attorney’s assessment of the overall claims in the case against the DHCS’ estimate will be the most contentious point in reducing the lien down. Compensatory damages, in particular, such as pain and misery and loss of personal happiness, are subjective; therefore add all accessible proof to bolster your overall damages claims. Additionally, the attorney can request Medi-Cal reduce its’ lien to pay for a fair pro-rata share of the attorney fees required to obtain the settlement or jury verdict (from which Medi-Cal is then paid).
CONCLUSION
As we discussed, if you’re loved one (s) have suffered a wrongful death, reach out to me for free case evaluation or to answer any questions you may have.