An Act To Allow the Reduction of a MaineCare Lien
Maine Legislature, Session 130, LD 0461
Committee: Health and Human Services
Sponsors: CARDONE
Amends: 22 MRSA §14

Legislative Document
No. 461
H.P. 337
House of Representatives, February 16, 2021
An Act To Allow the Reduction of a MaineCare Lien
Received by the Clerk of the House on February 11, 2021.  Referred to the Committee on 
Health and Human Services pursuant to Joint Rule 308.2 and ordered printed pursuant to Joint 
Rule 401.
ROBERT B. HUNT
Clerk
Presented by Representative CARDONE of Bangor.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §14, sub-§1, as amended by PL 2007, c. 381, §1, is further 
amended by amending the 2nd blocked paragraph to read:
The commissioner's right to recover the cost of benefits provided constitutes a statutory 
lien on the proceeds of an award or settlement from a 3rd party if recovery for MaineCare 
costs was or could have been included in the recipient's claim for damages from the 3rd 
party to the extent of the recovery for medical expenses.  The commissioner is entitled to 
recover the cost of the benefits actually paid out when the commissioner has determined 
that collection will be cost-effective to the extent that there are proceeds available for such 
recovery after the deduction of reasonable attorney's fees and litigation costs from the gross 
award or settlement from that portion of the award or settlement attributable to past medical 
expenses paid by MaineCare after the pro rata deduction of reasonable attorney's fees and 
litigation costs.  In determining whether collection will be cost-effective, the commissioner 
shall consider all factors that diminish potential recovery by the department, The portion 
of the award or settlement attributable to past medical expenses paid by MaineCare must 
be apportioned taking into consideration the full value of the recipient’s claim and the 
fraction by which it has been reduced due to factors including but not limited to questions 
of liability and comparative negligence or other legal defenses, exigencies of trial that 
reduce a settlement or award in order to resolve the recipient's claim and limits on the 
amount of applicable insurance coverage that reduce the claim to the amount recoverable 
by the recipient.  The department's statutory lien may not be reduced to reflect an 
assessment of a pro rata share of the recipient's attorney's fees or litigation costs.  If an 
award is established by a court judgment, and the judgment allocates the portion of the 
award attributable to past medical expenses, that allocation is binding.  If the commissioner 
and a recipient are unable to agree on an allocation of the amount of recovery attributable 
to past medical expenses paid by MaineCare, either party may submit the matter to a court 
for a determination of the allocation.  The commissioner may, at the commissioner's 
discretion, compromise, or otherwise settle and execute a release of, any claim or waive 
any claim, in whole or in part, if the commissioner determines the collection will not be 
cost-effective or that the best possible outcome requires compromise, release or settlement.
SUMMARY
This bill provides that MaineCare's lien applies to the portion of the award or settlement 
attributable to past medical expenses paid by MaineCare.  If the judgment of the court 
allocates the portion of the award attributable to past medical expenses, that allocation is 
binding.  Otherwise, if the commissioner and the recipient cannot agree on the allocation, 
either party may submit the matter to a court for the court to determine the allocation.