Medicaid Subrogation Process

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. 

The Social Welfare Act § 400.106

For the purpose of Medicaid subrogation, an accident is an incident that results in physical and/or mental injury. The 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.

The beneficiary, their representative, or their attorney is legally required to let MDHHS know when a lawsuit is filed.  TPL then determines if the Medicaid program has paid any injury-related medical claims and will pursue repayment from the responsible party.

 Notification

The preferred method for notification:

Other options:

Fax to: (517) 346-9876

Mail to: MDHHS Third Party Liability PO Box 30435 Lansing, MI 48909

Required information includes the full name of the beneficiary, the beneficiary date of birth, the Medicaid beneficiary ID number or the beneficiary Social Security Number, and the date of the incident.

DCH-1183 Authorization to Disclose Protected Health Information

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