Casualty recovery occurs when the Department of Human Services' (DHS) Division of Third Party Liability (TPL) is notified that a Medicaid recipient is seeking compensation for a personal injury where Medicaid may have paid claims related to the incident.
Notification is mandatory. TPL provides an itemized statement for claims MA paid as a result of the incident and any cash assistance paid between the date of the incident and the conclusion of the case.
For Attorneys and Business Partners who wish to contact DHS regarding a personal injury matter, please click on the link to sign up for and use the TPL Web Portal.
Additional Information
- Settlement Sheets: A Proposed Distribution Sheet (PDS) must be provided to verify the gross amount of the award, fees, and costs, the client's net, and compare the information to the amount of the claim. A verbal confirmation of the settlement amount is not acceptable. Pa.R.P.C.1.15(b) requires attorneys to provide the department with a full accounting of funds in which the department has an interest. If the PDS amount does not match the amount provided in the settlement check, the department will not process the payment. A final distribution sheet must be submitted even when the check for the amount received matches the PDS amount.
- Special Needs Trusts: Established with the resources of a disabled individual for the purpose of allowing the individual to qualify for MA. View/download the Special Needs Trust Fact and Information Sheet.
Contact TPL
Legal Links
- Federal Mandate: Title XIX §1902(a)(25)
- State Statute: 62 P.S. §1409
- State Regulation: 55 Pa. Code §259
- Cash Assistance Statute: 23 Pa.C.S. §4604(d)