Subrogation Information

Pursuant to New York’s General Obligations Law (GOL) §5-335, “no person entering into such a settlement shall be subject to a subrogation claim or claim for reimbursement by an insurer and an insurer shall have no lien or right of subrogation or reimbursement against any such settling person or any other party to such a settlement, with respect to those losses or expenses that have been or are obligated to be paid or reimbursed by said insurer.” In accordance with New York’s GOL §5-335, MetroPlusHealth does not have and cannot assert a lien to recover medical payments made for its members.

However, New York’s GOL §5-335 does not apply to the recovery of benefits provided by Medicare or Medicaid.  If the individual is receiving benefits as a Medicaid beneficiary, New York State contracts with Health Management Systems, Inc. (HMS) to handle Medicaid casualty recoveries for New York State of Health Medicaid recipients with personal injury lawsuits. If the individual is a Medicaid recipient, then you should contact HMS at 1-(877)-331-1460 or DOH Third Party Liability at 518-473-5330 regarding medical liens or subrogation.  If your client is a Medicare recipient, please contact MetroPlus counsel at [email protected] regarding medical liens or subrogation.

If you need an official response from MetroPlus Health Plan, please send your request to [email protected].