2017 ORS 416.540¹
Lien of department and authority
  • assignment of lien to prepaid managed care health services organization or coordinated care organization

(1) Except as provided in subsection (2) of this section and in ORS 416.590 (Procedure when recipient is minor), the Department of Human Services and the Oregon Health Authority shall have a lien upon the amount of any judgment in favor of a recipient or amount payable to the recipient under a settlement or compromise for all assistance received by such recipient from the date of the injury of the recipient to the date of satisfaction of such judgment or payment under such settlement or compromise.

(2) The lien does not attach to the amount of any judgment, settlement or compromise to the extent of attorney’s fees, costs and expenses incurred by a recipient in securing such judgment, settlement or compromise and to the extent of medical, surgical and hospital expenses incurred by the recipient on account of the personal injuries for which the recipient had a claim.

(3) The authority may assign the lien described in subsection (1) of this section to a prepaid managed care health services organization or a coordinated care organization for medical costs incurred by a recipient:

(a) During a period for which the authority paid a capitation or enrollment fee or a payment using a global payment methodology; and

(b) On account of the personal injury for which the recipient had a claim.

(4) A prepaid managed care health services organization or a coordinated care organization to which the authority has assigned a lien shall notify the authority no later than 10 days after filing notice of a lien.

(5) For the purposes of ORS 416.510 (Definitions for ORS 416.510 to 416.610) to 416.610 (Action against recipient who fails to provide notice of claim), the authority may designate the prepaid managed care health services organization or the coordinated care organization to which a lien is assigned as its designee.

(6) If the authority and a prepaid managed care health services organization or a coordinated care organization both have filed a lien, the authority’s lien shall be satisfied first. [Formerly 411.558; 2001 c.600 §4; 2009 c.595 §348; 2011 c.602 §51; 2012 c.8 §27]

Notes of Decisions

Where assistance grants were made to children, settle­ments due parents were subject to lien because “recipient” refers to family unit rather than individuals. Christensen v. AFSD, 122 Or App 71, 857 P2d 162 (1993)

Recovery against settle­ment of per­sonal injury claim is prohibited except to extent that settling party’s legal liability is related to need for Medicaid-funded treat­ment. AFSD v. Northland Ins. Co., 139 Or App 92, 911 P2d 942 (1996), Sup Ct review denied

Recipient of settle­ment for per­sonal injury allegedly related to need for treat­ment may not assert lack of causa­tion as de­fense against lien. AFSD v. Northland Ins. Co., 139 Or App 92, 911 P2d 942 (1996), Sup Ct review denied

Medical, surgical and hospital expenses are “incurred” by recipient only to extent that recipient has paid or is legally obligated to pay expenses at time of settle­ment. King v. Adult and Family Services Division, 142 Or App 444, 921 P2d 1326 (1996)

Atty. Gen. Opinions

Prior right of Motor Vehicles Accident Fund or Adult and Family Services Division to reimburse­ment for costs of medical services provided indigent, (1980) Vol 41, p 257

1 Legislative Counsel Committee, CHAPTER 416—Recovery of Aid and Child Support, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ors416.­html (2017) (last ac­cessed Mar. 30, 2018).
 
2 Legislative Counsel Committee, Annotations to the Oregon Revised Stat­utes, Cumulative Supplement - 2017, Chapter 416, https://­www.­oregonlegislature.­gov/­bills_laws/­ors/­ano416.­html (2017) (last ac­cessed Mar. 30, 2018).
 
3 OregonLaws.org assembles these lists by analyzing references between Sections. Each listed item refers back to the current Section in its own text. The result reveals relationships in the code that may not have otherwise been apparent.