You are responsible for paying the lien(s) out of the settlement.   Therefore, the settlement amount has to be sufficient to compensate you and pay the lien(s).Medicaid is entitled to reimbursement, but the amount is negotiable.Other liens may be negotiable.If a doctor or another party has a lien, it means the party is paid out of the settlement for the medical treatment that was provided.Health insurance companies usually require reimbursement.