Vermont § 1910 - Liability of third parties; liens

§ 1910. Liability of third parties; liens

• (a) The Agency shall have a lien against a third party, to the extent of the amount paid
  by the Agency for medical expenses, on any recovery for that claim, whether by judgment,
  compromise, mediation, or settlement, whenever: (1) the Agency pays medical expenses for or on behalf of a recipient who has been injured
  or has an illness or disease as a result of negligence; and (2) the recipient asserts a claim against a third party for damages resulting from the
  injury, illness, or disease. (b)(1) The Agency shall have a lien against the insurer, to the extent of the amount paid
  by the Agency for past medical expenses, on any recovery from the insurer, whenever
  the Agency pays medical expenses or renders medical services on behalf of a recipient
  who has been injured or has an injury, illness, or disease and the recipient asserts
  a claim against an insurer as a result of the injury, illness, or disease. (2) Effective July 1, 2013, the recipient’s insurer or alleged liable party’s insurer,
  if any, shall take reasonable steps to discover the existence of the Agency’s medical
  assistance. Payment to the recipient instead of the Agency does not discharge the
  insurer from payment of the Agency’s claim. (c) A recipient who has applied for or has received medical assistance under this subchapter
  and the recipient’s attorney, if any, shall cooperate with the Agency by informing
  the Agency in writing within a reasonable period of time after learning that the Agency
  has paid medical expenses for the recipient. The recipient’s attorney shall take reasonable
  steps to discover the existence of the Agency’s medical assistance. (d) Any written notice provided to the Agency pursuant to subsection (c) of this section
  shall disclose the identity and address of any third party and his, her, or its insurer
  against whom the recipient has a right of recovery, and the name of the court in which
  the legal recovery action, if any, was brought. (e)(1) A recipient or an attorney on behalf of a recipient shall allocate the full amount
  paid by the Agency for past medical expenses to or for any recovery obtained by whatever
  means. (2) A recipient or an attorney on behalf of a recipient shall pay to the Agency, within
  30 days after receipt of settlement proceeds or recovery of a judgment, the full amount
  of the medical expenses owed to the Agency. If full payment of the required sum is
  not made to the Agency within the 30-day period, the recipient or his or her attorney
  shall place a sum equal to the full amount of the medical expenses paid in an escrow
  account pending an agreement, mediation, or judicial determination of the Agency’s
  right to the amount. (3) The Agency’s lien for its medical expenditures relating to the recipient’s injury,
  illness, or disease shall be given priority over all other claims on the total amount
  recovered. (4) In making the determination whether to pursue, reduce, or compromise a claim, the
  Agency may in its discretion consider the factual, evidentiary, and legal issues of
  liability between the recipient and any liable third party and the total amount available
  to satisfy the recipient’s claim. Where the amount of reimbursement the Agency can
  reasonably expect to recover exceeds the costs of such recovery, the Agency shall
  not be required to seek reimbursement from or may reduce or compromise a claim against
  any liable third party, the insurer, or both. Whether or not the Agency exercises
  its discretion shall not be subject to any claim of abuse of discretion. (f) A lien created under this section shall not be effective unless: (1) notice of the lien is filed in the office of the clerk of the town in which the Agency
  is located and contains the name and address of the recipient, acknowledgment of the
  recipient’s application for or receipt of medical assistance, and the name of the
  person alleged to be liable; and (2) the Agency mails a notice of the lien with a statement of the date it was filed to
  the person alleged to be liable. (g) The Agency shall send a copy of the notice of the lien required by subsection (f)
  of this section to the following persons, if the appropriate names and addresses can
  be determined: (1) the recipient for whom the Department has paid medical expenses; (2) any insurance carrier that may be ultimately liable; and (3) any attorney for the recipient. (h) Within 45 days after the filing of the notice of the lien, the Agency shall send an
  itemized statement of the medical expenses paid by the Agency for which the Agency
  seeks to perfect a lien to the persons listed in subsection (g) of this section. The
  notice provisions contained in this subsection may be waived by agreement of the parties. (i) The Agency may, on behalf of a recipient, file a civil action in the Superior Court
  in Washington County against a liable third party, the third party’s insurer, or both,
  to recover up to the full amount of medical expenses it has incurred on behalf of
  the recipient. The Agency may initiate this action only if: (1) the recipient has not initiated legal proceedings against the third party within one
  year after the occurrence of the injury, illness, or disease resulting, at least in
  part, from the actions or omissions, including negligence, of the third party; and (2) the time remaining under the statute of limitations for the action is six months or
  less. (j) The Attorney General shall be responsible for initiating actions on behalf of the
  Agency. (k) Whenever the Agency recovers under the lien and that recovery is the result of an
  action initiated by a recipient, the attorney for the recipient may withhold the Agency’s
  pro rata share of reasonably necessary attorney’s fees, costs, and expenses incurred
  in asserting the claim. If the Agency waives its right to reimbursement, it shall
  not be liable for any fees, costs, and expenses incurred by the recipient or attorney. (l) In cases in which the court has determined the amount of recovery allocated for past
  medical expenses, the Agency’s lien shall be limited to that amount. (Added 1995, No. 152 (Adj. Sess.), § 4; amended 2007, No. 192 (Adj. Sess.), § 6.014; 2011, No. 162 (Adj. Sess.), § E.307.3; 2013, No. 96 (Adj. Sess.), § 206.)