Benefit Recovery / Subrogation Claims

Under Federal Law, Medicaid must seek the recovery of funds spent on a recipient’s medical care from any liable third party. When a Medicaid recipient receives treatment for an injury or is involved in a tort settlement, Medicaid’s Third Party Division looks to identify any primary payment source. Potential sources include homeowners, automobile and other liability insurance as well as court-ordered restitution.

The Alabama Medicaid Agency has contracted with Health Management Systems (HMS) to enforce the Agency’s right to recovery in subrogation claims and requests for medical records. HMS performs the evaluation and case tracking functions of all casualty and litigation cases for Alabama Medicaid. HMS can be reached at 877-252-8949.

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