Mass. Gen. Laws ch. 152, sec. 46A — MA Code / Part I / Title XXI / Chapter 152 / Section 46A
Reimbursement for accident and health insurance benefits paid on compensable injuries; lien of insurers, et al., against award; child support claims
Status: in_force

Section 46A. If medical, dental, hospital or lost time weekly benefits have been paid or furnished under any group or nongroup policy of accident and health insurance or certificate providing for hospital, medical or dental service benefits of any hospital, medical or dental service corporation which excludes the obligation for which the employer or his insurer may be held liable under any workers' compensation law, with respect to a claim which is subsequently found to be compensable under this chapter, or an insurer or self-insurer subsequently makes payment with respect to such disability pursuant to this chapter, the accident and health insurer which issued said policy or the hospital, medical or dental service corporation which issued said hospital, medical or dental service benefit certificate of the employer may, at any time before an award of workers' compensation benefits or approval of a lump sum settlement is paid, file with the department a claim for reimbursement out of the proceeds of such award or lump-sum settlement. If cash assistance, relief or support, or medical assistance is paid to or on behalf of an employee or a dependent of an employee by the department of transitional assistance under chapter eighteen, chapter one hundred and seventeen, chapter one hundred and eighteen, or the division of medical assistance under chapter one hundred and eighteen E, with respect to a claim which is subsequently found to be compensable under this chapter, the department of transitional assistance and the division of medical assistance may, at any time before an award of workers' compensation benefits or approval of a lump sum settlement is paid, file with the division a claim for reimbursement out of the proceeds of such award or lump sum settlement. In those instances in which such a claim is filed, said accident and health insurer or hospital, medical or dental service corporation, the department of transitional assistance, the division of medical assistance or employer shall have a lien against the award, or lump sum, and upon satisfactory proof, the division or a member thereof shall order direct payment of the reimbursement to be made from such award or lump sum to the employer, health or accident insurer, hospital, medical or dental service corporations, the department of transitional assistance or the division of medical assistance who paid or furnished such benefits. If an employee owes past-due child support that is subject to a lien pursuant to section six of chapter one hundred and nineteen A, the IV–D agency may, at any time before an award of worker's compensation benefits is paid or approval of a lump sum benefit is given or any other nonperiodic compensation is made pursuant to this chapter, file with the division a claim for past-due child support out of the proceeds of such award or lump sum settlement or other nonperiodic compensation. In those instances in which a claim is filed and upon satisfactory proof, the division or a member thereof shall order direct payment of the past-due child support to be made from such award or lump sum or other nonperiodic compensation to the IV–D agency on behalf of the obligee to whom past-due support is owed. Such direct payment shall be made before payment of any claim of the department of transitional assistance and any claim of the division of medical assistance. The provisions of sections 6 and 17 of chapter 119A shall constitute the sole remedy for an employee to contest a lien for past due child support. When a lump sum settlement or award is proposed or any other nonperiodic compensation is made or proposed pursuant to this chapter and the employee and the lienholder are unable to agree on a fair and reasonable amount to discharge a lien or claim filed pursuant to this section against the lump sum settlement or award provisions of this section or against any other nonperiodic compensation pursuant to this chapter, the reviewing board shall have the right to determine the fair and reasonable amount to be paid out of the lump sum settlement, award or other nonperiodic compensation to discharge the lien; provided, however, that in determining what amount is fair and reasonable, the reviewing board shall give primary consideration to the interests of the children of the employee in receiving past due child support and the public policy of the commonwealth that children shall be maintained, as completely as possible, from the resources of their parents, as provided in section 1 of chapter 119A; and, provided further, that if after payment of any attorneys' fees and any claim of the IV–D agency, the remaining amount of the award or lump sum or other nonperiodic compensation is insufficient to satisfy in full any competing claim of the department of transitional assistance and the division of medical assistance, the department and the division each shall be entitled to its respective pro rata share of such award or lump sum or other nonperiodic compensation. Upon the payment of such sums as found by the reviewing board to be fair and reasonable, the lien or claim against the award, lump sum or other nonperiodic compensation shall be discharged. In no event shall the reimbursement exceed the amount of the award or lump sum or other nonperiodic compensation.

Section 46A. If medical, dental, hospital or lost time weekly benefits have been paid or furnished under any group or nongroup policy of accident and health insurance or certificate providing for hospital, medical or dental service benefits of any hospital, medical or dental service corporation which excludes the obligation for which the employer or his insurer may be held liable under any workers' compensation law, with respect to a claim which is subsequently found to be compensable under this chapter, or an insurer or self-insurer subsequently makes payment with respect to such disability pursuant to this chapter, the accident and health insurer which issued said policy or the hospital, medical or dental service corporation which issued said hospital, medical or dental service benefit certificate of the employer may, at any time before an award of workers' compensation benefits or approval of a lump sum settlement is paid, file with the department a claim for reimbursement out of the proceeds of such award or lump-sum settlement. If cash assistance, relief or support, or medical assistance is paid to or on behalf of an employee or a dependent of an employee by the department of transitional assistance under chapter eighteen, chapter one hundred and seventeen, chapter one hundred and eighteen, or the division of medical assistance under chapter one hundred and eighteen E, with respect to a claim which is subsequently found to be compensable under this chapter, the department of transitional assistance and the division of medical assistance may, at any time before an award of workers' compensation benefits or approval of a lump sum settlement is paid, file with the division a claim for reimbursement out of the proceeds of such award or lump sum settlement. In those instances in which such a claim is filed, said accident and health insurer or hospital, medical or dental service corporation, the department of transitional assistance, the division of medical assistance or employer shall have a lien against the award, or lump sum, and upon satisfactory proof, the division or a member thereof shall order direct payment of the reimbursement to be made from such award or lump sum to the employer, health or accident insurer, hospital, medical or dental service corporations, the department of transitional assistance or the division of medical assistance who paid or furnished such benefits.

If an employee owes past-due child support that is subject to a lien pursuant to section six of chapter one hundred and nineteen A, the IV–D agency may, at any time before an award of worker's compensation benefits is paid or approval of a lump sum benefit is given or any other nonperiodic compensation is made pursuant to this chapter, file with the division a claim for past-due child support out of the proceeds of such award or lump sum settlement or other nonperiodic compensation. In those instances in which a claim is filed and upon satisfactory proof, the division or a member thereof shall order direct payment of the past-due child support to be made from such award or lump sum or other nonperiodic compensation to the IV–D agency on behalf of the obligee to whom past-due support is owed. Such direct payment shall be made before payment of any claim of the department of transitional assistance and any claim of the division of medical assistance. The provisions of sections 6 and 17 of chapter 119A shall constitute the sole remedy for an employee to contest a lien for past due child support.

When a lump sum settlement or award is proposed or any other nonperiodic compensation is made or proposed pursuant to this chapter and the employee and the lienholder are unable to agree on a fair and reasonable amount to discharge a lien or claim filed pursuant to this section against the lump sum settlement or award provisions of this section or against any other nonperiodic compensation pursuant to this chapter, the reviewing board shall have the right to determine the fair and reasonable amount to be paid out of the lump sum settlement, award or other nonperiodic compensation to discharge the lien; provided, however, that in determining what amount is fair and reasonable, the reviewing board shall give primary consideration to the interests of the children of the employee in receiving past due child support and the public policy of the commonwealth that children shall be maintained, as completely as possible, from the resources of their parents, as provided in section 1 of chapter 119A; and, provided further, that if after payment of any attorneys' fees and any claim of the IV–D agency, the remaining amount of the award or lump sum or other nonperiodic compensation is insufficient to satisfy in full any competing claim of the department of transitional assistance and the division of medical assistance, the department and the division each shall be entitled to its respective pro rata share of such award or lump sum or other nonperiodic compensation. Upon the payment of such sums as found by the reviewing board to be fair and reasonable, the lien or claim against the award, lump sum or other nonperiodic compensation shall be discharged. In no event shall the reimbursement exceed the amount of the award or lump sum or other nonperiodic compensation.