Frequently Asked Questions

General Information

What is subrogation? 
Subrogation is the substitution of one person into the place of another with respect to rights, claims, or securities. Medicaid subrogates when a Medicaid recipient has been injured and someone other than the person or party at fault pays for all or some of the damages resulting from the injury. 


Can your office give me subrogation information for Medicare? 
No.  Medicare is a federal program.  For information about Medicare reimbursement, visit: https://www.cob.cms.hhs.gov/MSPRP


Who do I contact if I have a Managed Care Plan?
Medicaid managed care plans are separate entities from Medicaid whose subrogation rights are also protected by statute. Please contact the specific Managed Care Plan to inquire about claims and their subrogation process: http://www.michigan.gov/documents/mdch/MHP_Service_Area_Listing_326102_7.pdf 

 

Information for Beneficiaries

I received a letter asking me about an accident. What is meant by accident? 
For the purpose of Medicaid subrogation, an accident is an incident that results in mental and/or physical injury. Injury may occur at work, in an auto accident, at school, from a medical procedure, from an assault, or on someone’s property including a fall or dog bite.
NoteIf you received a questionnaire and were not injured in an automobile, work, medical, school, assault or other type of accident, please state so on the front of the questionnaire and return it using the self-addressed stamped envelope or call (517) 335-8760.


I have Medicaid and was injured in an accident. Why am I still receiving bills? 
For all questions regarding Medicaid coverage and billing please contact the Beneficiary Hotline at (800) 642-3195.


Do I need to hire a lawyer?
The decision to hire a lawyer regarding an accident or injury is at the discretion of the individual who was injured. Medicaid staff persons are not able to provide legal advice.


Can Medicaid recommend a lawyer for me? 
Medicaid staff persons are not legal advisors and are unable to recommend a lawyer. The State Bar of Michigan offers a Lawyer Referral Service for some counties. Local county bar association offices may also provide that service.


Will Medicaid file a lawsuit for me?
Medicaid will not file a lawsuit on behalf of a Medicaid beneficiary.


Why does Medicaid have a lien against my lawsuit?
While attorneys typically refer to the amount owed to Medicaid as a lien, it is actually a subrogation amount that must be paid back to the state.  The Medicaid application has an assignment of benefits section.  This section says that when Medicaid pays the cost of hospital, surgical, or medical services, Medicaid has a right to recover costs from a third person, or public, or private contractor, except Medicare.

 
Please refer to the question “What is subrogation?” for more information. 


Who is responsible for paying the Medicaid subrogation amount?
Medicaid pursues repayment of its claims via subrogation when another party-typically an insurance such as workers’ compensation or auto insurance is responsible. Medicaid will also pursue repayment when a defendant is found responsible for an assault.


Will Medicaid take all of the benefits from my lawsuit?
Per Michigan law (MCL 400.106) Medicaid is not permitted to take more than half of the Medicaid beneficiary’s portion of the settlement amount.

 

Information for Attorneys

Why do I need to notify TPL about my Medicaid clients?
Medicaid is always the payer of last resort. The State of Michigan, as mandated by federal law, has enacted the following to require legal counsel to notify TPL when a client may be receiving Medicaid or participating in a Medicaid managed care plan:


MCL 400.106 (3): An individual receiving medical assistance under this act or his or her legal counsel shall notify the state department or the department of community health when filing an action in which the state department or the department of community health may have a right to recover expenses paid under this act. If the individual is enrolled in a contracted health plan, the individual or his or her legal counsel shall provide notice to the contracted health plan in addition to providing notice to the state department.


In addition, as a condition of eligibility, all applicants are required to acknowledge the subrogation interests of Medicaid whenever they are involved in a legal/insurance matter and agree to cooperate in that effort.

Will an attorney be compensated for work in recovering medical expenses for the State?  
Pursuant to MCLA 14.28-et seq, MSA 3.181, only the Michigan Office of Attorney General can represent the State of Michigan in legal proceedings.  However, most cases are not referred to the attorney general.  TPL negotiates with private attorneys to obtain Medicaid recoveries in a fair manner.  TPL does not pay attorney fees.

Where do I send a subpoena for Medicaid records?    
Please do not send subpoenas directly to Third Party Liability.  All subpoenas are processed by the MDHHS Office of Legal Affairs.  
Please send to: 

Department of Health and Human Services
Office of Legal Affairs
P.O. Box 30195
Lansing, Michigan 48909 

Email: MDHHS-Subpoena@michigan.gov
Fax: 517-241-1200

Where do I mail payments?  
Mail payments to: 

Accounting Divison-Cashier's Office
Michigan Department of Health and Human Services
320 Walnut
Lansing, MI  48909 

 

MINotifyTPL Questions

Why do I need to give TPL my contact information if I am a trustee for a SNT?
Special needs trusts are specifically set up to allow certain disabled individuals the use of money held for their personal use without losing Medicaid eligibility or other government benefits. The trustee for a special needs trust is responsible for understanding the legal notification requirements, the spending limitations, and the process for dissolving the trust. It is important that TPL have trust account and contact information- and that you have easy access to TPL for questions and concerns that you may have.

Will the information be securely sent?
Yes. TPL is accustomed to handling sensitive and protected information. Your submitted information will be securely stored behind the State of Michigan firewall and handled by the same professional staff that currently reviews your requests.

Can I notify you about more than one client at a time?
Yes. MiNotifyTPL has been designed to make it as easy as possible for large volume offices to efficiently send requests for multiple clients.


How do I know that you've received the information?
You will receive an automatic email response confirming that your request has been received by TPL. The response will contain a Submission ID that can be used for future update requests. The response will not contain any of the submitted content, so if you want a copy of the information make sure you save the summary page before exiting the program. If you haven't received any response from us within 14 days, please contact us.

How long will it take to get a response?
That depends largely on the method you prefer for response. We process over 90% of our requests within 3 business days. MiNotifyTPL will be more efficient, cheaper, safer, and at least as fast as our current system.

Does this process guarantee that a response will be (even) quicker?
Currently, over 90% of our requests are responded to within 3 business days. Your online request will be at least this fast. If you need an "urgent-same day" request, please call TPL to request it directly from the appropriate staff member, as you would currently. Requests sent using the fax/mail methods will be processed just as they are now.

What are the benefits of submitting online?
MiNotifyTPL will allow your office to conveniently notify, request updates from and provide documents to TPL. Providing information electronically will save time, postage and paper.

Can we still notify you the old way?
Yes, however, we've designed MiNotifyTPL with convenience, administrative costs savings, and privacy in mind. It is also an evolving system with more enhancements planned. If you've used MiNotifyTPL and have suggestions for improvements, please let us know.

Does my response come back to me through MiNotifyTPL?
Not at this time. We are working on a system that will allow you to request and access necessary information through a safe and secure portal. Until then, we will send your requested information by fax, email, or mail.

Can I get my response by email?
Yes, we can send you a response by email. Please remember that in order for us to send medically protected or personally identifiable information in an email, we must password protect it. If you would like your response sent by email, you may request it using MiNotifyTPL or by calling a staff person. In either case, you will be given your password by phone. We are glad to send your requested information in whatever format you desire.

If I submit incorrect information, how can I correct it?
You can call our general number (517) 335-8760 to speak with someone or submit changes through the MiNotifyTPL update request.

What if I get timed out of the application?
For security's sake, we will have a timer on this application, however, for your convenience, MiNotifyTPL will allow you to save frequently used information. This will keep your content/time loss to a minimum.

I need to talk to someone!
Please call the general number (517) 335-8760 or the number for a case-specific staff person whenever you need to discuss an issue.

Can I submit online if I don't have all the information you're asking for?
Generally speaking, yes. Obviously there is some basic information we must have to fulfill your request and using MiNotifyTPL does not require more information than our paper process. Additional information is useful because it helps TPL staff process, keep track of, and properly notify all parties in a case.

Can I simply request an update?
Yes. In fact, requesting updates, amending an existing file, or providing documents is an easy process requiring only minimal information. If you use the Submission ID number, the process is even simpler.

What is the Submission ID?
The Submission ID is a system-generated number that is unique for each individual case. Once an ID number is generated for your client, it can be used as a simple, safe, and time-saving reference. Using the Submission ID when requesting an update or forwarding documents will automatically give TPL all the information we need to find the case and process your request.

What is TPL's process once this information is received?
Third Party Liability will have access to your request as soon as it is submitted and will have it assigned to a staff member within one business day. Like all incoming requests, it is our goal to have a response prepared and sent via your preferred method within 3 business days.

Something isn't working...
You may experience some difficulties using MiNotifyTPL if you've enabled or disabled certain browser settings, or if your browser is an older version. Please ensure your browser is up-to-date, make sure it's accepting cookies, and that you haven't disabled scripting. If you're using Internet Explorer, please ensure you are not in Compatibility Mode: 

 

  1. In Internet Explorer, open the Tools menu and select Compatibility View Settings 
  2. Select MiNotifyTPL under "Websites you've added to Compatibility View" 
  3. Click Remove 

If you don't see MiNotifyTPL listed, or if you still see a warning about Compatibility View after following the steps above: 

 

  1. In Internet Explorer, open the Tools menu and select Compatibility View Settings 
  2. At the bottom of the window, make sure that the boxes next to "Display all websites in Compatibility View" is not checked" 
  3. Click Close 


Note: If your Windows computer is administered by your organization, you may not be able to access Compatibility View settings or remove MiNotifyTPL from the list. Contact your organization's administrator or helpdesk for help.

How do I reuse attorney data?
The "Remember Attorney Information" feature allows the submitter to save information and easily choose from multiple attorneys within the same firm. 
To enable this feature, click the "Remember Attorney Information" check box at the bottom of any of the Attorney Information screens. Once enabled, each attorney entered into a submission will be saved. Attorney information can be easily accessed by clicking the little blue box next to "Contact Details" and viewing the saved names in the dropdown. 


For the purposes of saving, attorneys fall into one of three categories - plaintiff attorneys (including trust and annuity attorneys), defense attorneys, and third-party administrators. A saved attorney will only be found in the dropdown under which it had been initially saved. For example, an attorney saved as "plaintiff" will only be viewable and accessible under the plaintiff attorney path. 


If you need to edit a saved attorney, load the attorney and make the necessary changes, then click next - if saving is enabled, the saved attorney will be updated with your changes. You may also delete a saved attorney by clicking the icon. 

If the "remember" checkbox is unchecked, saving is disabled. New items will not be saved, but any existing items will still be available to load. 

Attorney data is saved in HTML5 Web Storage - much like cookies, but faster and more secure. This data is saved within the user's browser - it is only accessible by the application that set it, in the browser it was set in. Browsers manage their web storage along with cookies though, so please be aware that if you clear your browser's cookies you will also be permanently deleting any saved attorney data from MiNotifyTPL.