Planning for Life

MassHealth Permitted Late Intervention in Personal Injury Case

Posted by Harry S. Margolis on May 22, 2018

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By Harry S. Margolis

Hand about to bang gavel on sounding block in the court room

In 2009, Evelyn E. Gries was hit by a car driven by Annmarie B. Hunt. Ms. Gries died about a year and a half later and a year and a half after that her estate brought suit against Ms. Hunt. In another year and a half (there's a pattern here) at the end of 2013, the parties settled for the full amount of Ms. Hunt's insurance, $250,000. They stipulated to the dismissal of the lawsuit at the beginning of 2014.

None of the parties notified MassHealth of the suit or their settlement. MassHealth had a lien on the settlement for $18,026.44 for the medical care it had paid for on behalf of Ms. Gries after the accident. In 2015, MassHealth began sending demand letters to the plaintiffs' (the son and daughter of Ms. Gries) counsel and in 2016 moved to intervene in the original action. The plaintiffs argued that the motion to intervene was untimely. The trial court disagreed and the plaintiffs appealed the matter to the Appeals Court.

In Raymond Bence, et al. v. Annmarie B. Hunt, et al. (Mass. App. Ct. 17-P-456, March 2, 2018), the Appeals Court affirms the trial court finding that it's not too late for MassHealth to intervene and orders payment to MassHealth of its full lien amount. On the timeliness issue, the Court, citing an earlier case, states that "there can be no final judgment in a suit subject to a MassHealth lien unless MassHealth receives 'written notice and a reasonable opportunity to intervene or otherwise perfect their rights to recovery,'" none of which occurred here.

The Court also rejects several substantive arguments made by the plaintiffs, that the state's laws don't allow MassHealth's lien to reach the settlement, that the lien cannot reach damages for wrongful death, and that the Ahlborn case bars recovery. These claims were rejected in part on the Court's reading of the various relevant statutes, but also because they were not raised below and because the settlement did not clarify that the funds paid were only for wrongful death and not in part for negligence and to recover medical expenses incurred.

I suspect that if the settlement had stated that the funds were paid only for wrongful death, the Court would have found this allocation to be self-serving. In any event, this case makes it crystal clear that personal injury attorneys need to give notice to MassHealth and include it in any settlement negotiations.

Topics: MassHealth, personal injury settlement, MassHealth lien

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