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Medi-Cal, Reductions of Liens

Goldberg v. Superior Court (1994) 23 Cal. App.4th 1378 - Discreation of Court to reduce the liens of minors in a minor's compramise.

We need to include the below language in an attachment so that the judge realizes how this lien is arrived at becuse she is not going to have this at her finger tips and she is going to want to know how the lien got reduced. In other words we need to really spell it out in an attachment.

This reduction is based on the W & I Code Section 14124.72 - The reduction of the lien that DHS granted is as follows 25% - Pro Rata Share of costs equaling $62.48 - this formula is worked as follows - Costs x the lien amount divided by the settlement.

Standard Reduction Rule

W & I Code Section 14124.72

14124.72. (a) Where an action is brought by the director pursuant to Section 14124.71, it shall be commenced within the period prescribed in Section 338 of the Code of Civil Procedure. (b) The death of the beneficiary does not abate any right of action established by Section 14124.71. (c) When an action or claim is brought by persons entitled to bring such actions or assert such claims against a third party who may be liable for causing the death of a beneficiary, any settlement, judgment or award obtained is subject to the director's right to recover from that party the reasonable value of the benefits provided to the beneficiary under the Medi-Cal program, as provided in subdivision (d). (d) Where the action or claim is brought by the beneficiary alone and the beneficiary incurs a personal liability to pay attorney's fees and costs of litigation, the director's claim for reimbursement of the benefits provided to the beneficiary shall be limited to the reasonable value of benefits provided to the beneficiary under the Medi-Cal program less 25 percent which represents the director's reasonable share of attorney's fees paid by the beneficiary and that portion of the cost of litigation expenses determined by multiplying by the ratio of the full amount of the reasonable value of benefits so provided to the full amount of the judgment, award, or settlement.

Fifty Percent Rule

14124.78. Except as otherwise provided in this article, notwithstanding any other provision of law, the entire amount of any settlement of the injured beneficiary's action or claim, with or without suit, is subject to the director's claim for reimbursement of the reasonable value of benefits provided and any lien filed pursuant thereto, but in no event shall the director's claim exceed one-half of the beneficiary's recovery after deducting for attorney's fees, litigation costs, and medical expenses relating to the injury paid for by the beneficiary.

Whichever the client would recieve more under Standard Reduction Rule 14124.72. or Fifty Percent Rule 14124.78, Medi-Cal will grant.

Under Standard Reduction Rule 14124.72 the reduction would be $6, 150.35 and XXXXXXX would recieve $11,930.58

Under Fifty Percent Rule 14124.78 the reduction would be 50% of Richard's net after attorreny's fees an costs ($18, 080.93) which would give Medi-Cal $9,040.46 and XXXXXXX $9,040.47.