How Ahlborn Caps What State Medicaid Can Take

The pro-rata methodology, the federal anti-lien statute, and the math that limits state Medicaid recovery in personal injury settlements.

Download the Medicaid Lien Resolution Fundamentals White Paper

Read our Blog: Ahlborn Explained

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The Cost of Missing an Ahlborn Reduction

State Medicaid agencies and their recovery contractors, including Optum and Conduent, often demand the full amount Medicaid paid. That full reimbursement demand can reach into pain and suffering, lost wages, and future earnings damages.

Federal law does not allow it. Ahlborn limited state recovery to the medical portion of the recovery. Wos struck down arbitrary statutory caps.

Without a clear pro-rata calculation and a documented allocation, the injury victim can pay back too much of an asserted Medicaid lien.

What you will learn from the White Paper

How Ahlborn limits state Medicaid recovery to the medical portion of a settlement

The pro-rata formula the Supreme Court endorsed, and how to apply it

How Wos requires a procedure to challenge a statutory default allocation

What Gallardo changed for future medical damages

How recovery contractors apply the framework in their initial demand letters

Where state procedure can compress or expand the result

The Industry Leader in Medicaid Lien Resolution

Synergy is the industry leader in healthcare lien resolution for personal injury firms. The Synergy team includes attorneys and lien specialists who, using these principles, reduce Medicaid liens across all fifty states. Synergy resolves Medicaid liens at scale, trust our hundreds of years of combined Medicaid subrogation experience and expertise to get the best outcome.

Free Resource: Medicaid Lien Resolution Fundamentals

Get the federal framework, the case law, and the pro-rata math in an easily digestible form. Download the Medicaid Lien Resolution Fundamentals guide.

Have a Challenging Medicaid Lien?

If you have an open Medicaid lien that has not been reduced, send it over. Get a free lien reduction consult.

TESTIMONIALS

“Synergy Settlement Services offered clear and prompt guidance on their lien reduction services. Their team members were easy to work with and offered candid advice at every step on how to maximize our client’s settlement. Their work is much appreciated, and we recommend Synergy for lien reduction services.”

“Synergy’s focus on these liens allows our office to better represent our clients, by allowing us to focus on what we do best – litigation. Further, Synergy’s expertise in the Medicare and lien world provides a sense of security for the client and us as attorneys to ensure we are providing the client the best advise possible.”

“We fought numerous defendants to obtain a record‑breaking settlement but, in the end, it was Synergy who stepped up to help my office protect our client’s settlement proceeds. After obtaining millions of dollars from five different defendants, we were left with an ERISA medical insurance lien that refused to compromise and wanted 100% reimbursement. I attempted to negotiate with them, and they refused to accept any reductions whatsoever. Our client suffered a serious brain injury and there was no way we wanted an insurance company to get paid back in full. Synergy went to work on them and in short order they obtained a major reduction in the ERISA lien, putting substantially more money in my client’s pocket.”

“We were able to save our clients millions of dollars through Synergy’s healthcare lien resolution program."

“Newsome Melton has worked with Synergy for many years. Time and time again, Synergy has proven to be a great partner, committed to going above and beyond to maximize our clients’ net recovery.”

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The Synergy team will work diligently to ensure your case gets the attention it deserves. Contact one of our legal experts and get a professional review of your case today.

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