Fire Victim Trust

158. What is a Medical Lien?

A Medical Lien occurs when a healthcare insurer/payor (such as Medicare, Medicaid, the Department of Veterans Affairs, and/or others) pays for medical items, services, and/or prescription drugs related to your compensable Personal Injury and/or Emotional Distress Claim(s). Medical Liens are sometimes called “healthcare liens.” If you receive a Determination Notice advising that you are eligible for compensation and have an approved Personal Injury or Emotional Distress Claim, the healthcare insurer/payor may be entitled to reimbursement (that is, be paid back for the compensable, injury-related care) for its payments out of your award. This right applies only to medical expenses or services related to the injuries and treatment on which your eligible claim is based. For example, if you received an award for pneumonia, medical expenses for treating your pneumonia may be subject to a Medical Lien, but medical expenses for an unrelated sprained ankle would not.

There are many different types of Medical Liens (including those asserted by Medicare (Parts A and B) Medi-Cal (California Medicaid)/other state Medicaid, the Department of Veterans Affairs, TRICARE, Indian Health Services, and private healthcare insurers for certain plans) where, under the Fire Victim Trust Agreement and Claims Resolution Procedures, there is a legal obligation to withhold payment.

159. Who is the Lien Resolution Administrator?

The Trustee and Claims Administrator appointed Wolf Garretson and BrownGreer PLC to serve as Lien Resolution Administrator and perform the healthcare administrative tasks for the Trust.

160. What are the procedures for identifying Medical Liens?

The Lien Resolution Administrator will work with Medicare and Medi-Cal (California Medicaid) to identify whether a Claimant who qualifies for an award based on personal injury or emotional distress is (or ever was) a Medicare (Parts A and B) or Medi-Cal beneficiary. The Lien Resolution Administrator also will work with the Private Lien Resolution Program (“PLRP”) Participating Private Health Plans to resolve any Medical Liens. Additionally, Part XI of the Claims Questionnaire requires you to identify any other insurers that covered your medical treatment related to your Personal Injury or Emotional Distress Claim(s). Those insurers include, but are not limited to, the Department of Veterans Affairs, TRICARE, Indian Health Services, private healthcare insurance plans, and other state (non-California) Medicaid agencies.

161. Which Medical Liens will the Lien Resolution Administrator affirmatively resolve for me? Are there any Medical Liens I must resolve myself?

Under the Trust Agreement, the Lien Resolution Administrator is responsible for affirmatively resolving Medical Liens with Medicare (Parts A and B), Medi-Cal (California Medicaid), PLRP Participating Private Health Plans (the list of PLRP Participating Private Health Plans is posted to the Home page in your Portal under Alerts) and any potential Medical Liens with the Department of Veterans Affairs (VA & CHAMP VA), TRICARE, Indian Health Services, and other state (non-California) Medicaid disclosed in the Claims Questionnaire.

You are responsible for resolving any other known Lien obligations with any private healthcare insurer that is not a PLRP Participating Private Health Plan and with any governmental agency that is not the Department of Veterans Affairs (VA & CHAMP VA), TRICARE, Indian Health Services, or other state (non-California) Medicaid. If you opted out of the PLRP and would otherwise be subject to the terms of that agreement, you are also responsible for resolving any private Liens from PLRP Participating Private Health Plans.

If you have questions about whether you must resolve a specific Medical Lien yourself, email the Lien Resolution Administrator at LRA@firevictimtrust.com or call (888) 664-1152.

162. Can I resolve my own Medical Lien (without assistance from the Lien Resolution Administrator)?

The Lien Resolution Administrator was appointed to ensure the satisfaction and discharge of Medical Liens with Medicare (Parts A and B), Medi-Cal (California Medicaid), PLRP Participating Private Health Plans, and any potential Medical Liens with the Department of Veterans Affairs (VA & CHAMP VA), TRICARE, Indian Health Services, and other state (non-California) Medicaid disclosed in the Claims Questionnaire. It is important that you (or your lawyer, if you are represented) do not individually contact or report your settlement from the Fire Victim Trust to any of these entities, as your reporting could cause duplication or delay in the resolution process and award payment.

If you (or your lawyer, if you are represented) are on notice of a Lien or resolved a Medical Lien that the Lien Resolution Administrator is affirmatively resolving (as specified above) related to your claim, send copies of your communications with the lienholder, including confirmation of the final lien amount, to the Lien Resolution Administrator by one of the following methods:

(c) Mail: By mail to Fire Victim Trust, P.O. Box 25936, Richmond, VA 23260, ATTN: LRA; or

(d) Delivery: By overnight carrier to Fire Victim Trust, c/o BrownGreer PLC, 250 Rocketts Way, Richmond, VA 23231, ATTN: LRA. 

The Lien Resolution Administrator will verify the final Lien amount before releasing any funds withheld for Medical Liens.

163. What types of Fire Victim Trust Claims are subject to potential Medical Lien withholdings?

Only Claimants with eligible Personal Injury and Emotional Distress (Zone of Danger and Nuisance) Claims are subject to potential Medical Lien withholdings. If your award is for any other Claim Type(s), the Trust will not withhold funds for Medical Liens.

164. I submitted a claim for a family member. Will it be subject to Medical Liens?

That depends. If your family member’s claim is based on personal injuries and/or emotional distress, it could be subject to Medical Liens associated with that family member’s compensable, injury-related medical care.

165. What happens if I do not resolve my Medical Liens?

If Medical Liens are not properly resolved, your health plan could stop paying for your medical bills or stop providing you with other benefits. A healthcare insurer's right to place a Lien on your award may be protected by law. This may obligate you to work with the insurers to resolve any Liens claimed against your award.

166. Should I report my award to a government agency or private insurer to whom I have a known lien obligation?

No. Do not report your award to any agency/insurer with whom the Lien Resolution Administrator is affirmatively resolving Medical Liens. Those agencies/insurers include Medicare (Parts A and B), Medi-Cal (California Medicaid), and PLRP Participating Private Health Plans (the list of PLRP Participating Private Health Plans is posted to the Home page in your Portal under Alerts), in addition to any potential Medical Liens from the Department of Veterans Affairs (VA & CHAMP VA), TRICARE, Indian Health Services, and other state (non-California) Medicaid disclosed in the Claims Questionnaire.

If you are aware of potential Lien obligations with other agencies/insurers, contact the applicable agency/insurer to determine what obligation you may have.

167. What if I identified a medical insurer on my Claims Questionnaire?

The Claims Questionnaire asked you to provide information about medical insurance used to cover any treatments for injuries related to your claim. Depending on the type of claim you make and the Claims Administrator's determination, the insurance information you provide may be used to contact and give notice to the insurer. Specifically, the Lien Resolution Administrator will affirmatively resolve any potential Medical Liens from the Department of Veterans Affairs (VA & CHAMP VA), TRICARE, Indian Health Services, and other state (non-California) Medicaid disclosed in the Claims Questionnaire. If you do not provide the Lien Resolution Administrator with enough information to contact the insurer or the insurer does not provide the Lien Resolution Administrator with the information it needs, you are responsible for resolving the potential Lien.

168. How do I know if I am subject to any potential Medical Lien withholdings?

The Claims Administrator posted a report (FVT 2633) to Portals that shows entitlement, Medical Lien statuses, holdback amounts while Liens are in the process of being finalized, and the amount of any withholding for finalized Medical Liens that Lien Resolution Administrator is resolving. All data in the FVT 2633 is as of the date of the report. The Claims Administrator will continue to add Claimants to the FVT 2633 until it reflects all Claimants with a submitted Claims Questionnaires. If you are represented by a lawyer, your lawyer will be able to provide you with this information. If you are not represented by a lawyer and do not use a Portal, email the Lien Resolution Administrator at LRA@firevictimtrust.com or call (888) 664-1152 with any questions about your entitlement and Medical Lien statuses.

Keep in mind that a holdback amount for Medical Liens does not necessarily mean that a Lien obligation exists that will require repayment.

169. I received a 30% and/or 45% Pro Rata payment already; will the Trust withhold funds from my next Pro Rata payment?

The Trust did not withhold funds for Medical Liens from any payments issued before the 45% Increased Pro Rata Payment Percentage Announcement on 2/1/22. If you received a 30% pro rata payment before 2/14/22 and/or a 45% pro rata payment before 1/30/23, the Trust may withhold funds for Medical Liens from your future pro rata payment(s) based on the Net Claim Amount paid to date for Personal Injury and Emotional Distress Claims.

Those who have received 45% payments will receive a 15% “true-up” payment to reach 60%, and the Trust will apply an additional holdback against the 15% payment only for those Claimants with unresolved Lien obligations where the Lien Resolution Administrator does not yet have a Claimed Lien Amount from the insurer/agency.

170. If I did not receive a Pro Rata payment before 1/30/23 and become eligible for payment, will the Trust withhold funds from my award?

Yes, if your award includes an eligible Personal Injury or Emotional Distress Claim and you have potential Medical Lien obligations, the Trust will withhold for Medical Liens.

171. Is there a maximum amount that the Trust will withhold from my Personal Injury or Emotional Distress Claim payment for Medical Liens?

For most Claimants, the maximum amount that the Trust will withhold is 33% of amounts paid to date. The specific amount withheld is unique to each Claimant and depends on the severity of your injuries; how many treatments you received for those injuries; whether you are or ever were a beneficiary of Medicare, Medi-Cal, or a PLRP Participating Private Health Plan; and the status of any Medical Liens asserted against your award. In the rare event that the funds held back from your pro rata payment(s) are insufficient to satisfy 100% of your Medical Lien obligations, the Lien Resolution Administrator will continue to hold back and pay up to 33% of any future pro rata payment(s) towards satisfying those Liens.

If you opted out of the PLRP and would otherwise be covered under that agreement, and you received medical treatment for injuries you submitted on your Claims Questionnaire, the Trust will withhold 100% of your pro rata payments for Personal Injury or Emotional Distress Claim awards issued after 2/14/22 until the Lien Resolution Administrator receives sufficient proof of satisfaction and discharge of the Lien.

The Trust will adjust any amount withheld as Medical Lien resolution takes place and Liens are satisfied and discharged or released. When the final Lien amount is determined, the Trust will use the withheld funds to pay the lienholder and pay the Claimant any remaining funds.

172. Will Medical Lien holdbacks or deductions paid to a lienholder consider any attorneys’ fees and costs that may also be owed to a law firm from a Trust payment?

In addition to the Lien Caps, the Lien Resolution Administrator’s agreements with insurers include procurement offset provisions that will automatically reduce any Lien by a certain percentage. Where Liens are resolved with insurers without a Trust-wide agreement, the Lien Resolution Administrator will work on a case-by-case basis to report fee/cost information to the insurer for offset consideration in establishing a final Lien amount. If you are an attorney and have questions about your fees/costs with respect to a Medical Lien holdback or payment, contact the Lien Resolution Administrator at LRA@firevictimtrust.com or call 1-888-664-1152.    

173. Can I object to the Medical Lien(s) asserted against my award?

If a PLRP Participating Private Health Plan asserts a Lien against your award and after the Lien Resolution Administrator’s audit that Lien is greater than $0, the Lien Resolution Administrator will calculate your Proposed Payable Lien Amount and present that to you. You may object to the Proposed Payable Lien Amount within 21 calendar days of when the Lien Resolution Administrator presents it to you.

For Medicare and Medi-Cal, as well as any Liens from the Department of Veterans Affairs (VA & CHAMP VA), TRICARE, Indian Health Services, other state (non-California) Medicaid disclosed in the Claims Questionnaire, and Liens for which the Trust receives notice from a governmental agency that is not the VA, TRICARE, or Indian Health Services or Liens for which the Trust receives notice from a private healthcare insurer not participating in the PLRP, the Lien Resolution Administrator will audit the Lien amount claimed by the agency/insurer to ensure the claims align with your compensable injuries, and the agreed-upon Lien amount after that audit is the Final Lien Amount.

174. I received a letter from Medicare/CMS; should I respond to it?

No. The Lien Resolution Administrator performs the healthcare administrative tasks for the Trust, including identifying and resolving Medical Liens from Medicare (Parts A and B). It is important that you do not contact Medicare directly to respond to a Conditional Payment or other type of letter. The Lien Resolution Administrator will work directly with CMS to resolve any potential Lien obligations. Your attempts to resolve the Liens yourself could cause duplication or delay in the recovery process and award payment.

If you receive any Lien documentation from Medicare, forward it immediately to the Lien Resolution Administrator by one of these methods:

(c) Mail: By mail to Fire Victim Trust, P.O. Box 25936, Richmond, VA 23260, ATTN: LRA; or

(d) Delivery: By overnight carrier to Fire Victim Trust, c/o BrownGreer PLC, 250    Rocketts Way, Richmond, VA 23231, ATTN: LRA. 

175. I received a letter from Medi-Cal or another state’s Medicaid agency; should I respond to it?

No. The Lien Resolution Administrator performs the healthcare administrative tasks for the Trust, including identifying and resolving Medical Liens from Medi-Cal (California Medicaid) and other state Medicaid agencies disclosed in the Claims Questionnaire. It is important that you do not contact the agency directly to respond to a letter. The Lien Resolution Administrator will work directly with the agency to resolve any potential Lien obligations. Your attempts to resolve the Liens yourself could cause duplication or delay in the recovery process and award payment.

If you receive any Lien documentation from Medi-Cal or any other, state Medicaid agency disclosed in the Claims Questionnaire, forward it immediately to the Lien Resolution Administrator by one of these methods:

(c) Mail: By mail to Fire Victim Trust, P.O. Box 25936, Richmond, VA 23260, ATTN: LRA; or

(d) Delivery: By overnight carrier to Fire Victim Trust, c/o BrownGreer PLC, 250 Rocketts Way, Richmond, VA 23231, ATTN: LRA. 

176. I received a letter from a PLRP Participating Private Health Plan and did not opt out of the PLRP; should I respond to it?

No. The Lien Resolution Administrator performs the healthcare administrative tasks for the Trust, including identifying and resolving Medical Liens from private insurers/health plans that participate in the PLRP (the list of PLRP Participating Private Health Plans is posted to the Home page in your Portal under Alerts). It is important that you do not contact any of these insurers/health plans directly to respond to a letter. The Lien Resolution Administrator will work directly with all PLRP Participating Private Health Plans to resolve any potential Lien obligations. Your attempts to resolve the Liens yourself could cause duplication or delay in the recovery process and award payment.

If you receive any Lien documentation from a PLRP Participating Private Health Plan, forward it immediately to the Lien Resolution Administrator by one of these methods:

(a) Email: To LRA@firevictimtrust.com;

(b) Facsimile: By facsimile to (804) 521-7299, ATTN: LRA;

(c) Mail: By mail to Fire Victim Trust, P.O. Box 25936, Richmond, VA 23260, ATTN: LRA; or

(d) Delivery: By overnight carrier to Fire Victim Trust, c/o BrownGreer PLC, 250 Rocketts Way, Richmond, VA 23231, ATTN: LRA. 

177. I have a private medical insurance plan that is not participating in the PLRP. Can they claim a Lien on my award?

Private insurance plans do not usually carry an obligation to withhold payment of settlement funds, like awards. However, most private insurance* plan documents (such as a contract or a plan booklet) contain provisions that require you to notify the insurer of any illness or injury that can be attributed to a third party. When this happens, and if you receive compensation from the third party, the insurer may demand repayment from that compensation. If you fail to comply with these provisions in your insurance plan, the company can take action against you later or deny future benefits.

If you receive notice of a potential Lien from a private insurer not participating in the PLRP, it is your (or your lawyer’s, if you are represented) responsibility to satisfy any potential Lien obligation outside the Trust.

* Reminder: Private health insurance coverage is offered through private, non-governmental entities. Private insurance policies are commonly referred to as insurance “plans.” Examples of private healthcare insurance include coverage provided by your (or a family member’s) employer or that you purchased from an insurance company. Private insurance plans often refer to the policy holder as a “subscriber” or “plan member.”

178. I received a letter from the Department of Veterans Affairs (VA and CHAMP VA), TRICARE, or Indian Health Services; should I respond to it?

No. The Lien Resolution Administrator performs the Healthcare Lien administrative tasks for the Settlement Program, including identifying and resolving any potential Medical Liens associated with the Department of Veterans Affairs (VA and CHAMP VA), TRICARE, or Indian Health Services disclosed in the Claims Questionnaire. It is important that you do not contact the agency directly to respond to a letter. The Lien Resolution Administrator will work directly with the agency to resolve any potential Lien obligations. Your attempts to resolve the Liens yourself could cause duplication or delays in the recovery process and award payment.

If you receive any Lien documentation from the Department of Veterans Affairs (VA & CHAMP VA), TRICARE, or Indian Health Services, forward it immediately to the Lien Resolution Administrator by one of these methods:

(a) Email: To LRA@firevictimtrust.com;

(b) Facsimile: By facsimile to (804) 521-7299, ATTN: LRA;

(c) Mail: By mail to Fire Victim Trust, P.O. Box 25936, Richmond, VA 23260, ATTN: LRA; or

(d) Delivery: By overnight carrier to Fire Victim Trust, c/o BrownGreer PLC, 250 Rocketts Way, Richmond, VA 23231, ATTN: LRA. 

179. I received a letter from a private healthcare insurer or governmental agency that is not a PLRP Participating Private Health Plan, the Department of Veterans Affairs (VA and CHAMP VA), TRICARE, Indian Health Services, or a non-California state Medicaid agency that was disclosed in the Claims Questionnaire; should I respond to it?

Yes, you should respond to the letter directly. You (or your lawyer, if you are represented) are responsible for resolving Medical Liens from (1) private insurers that are not participating in the PLRP; (2) government agencies that are not Medicare (Parts A and B) and Medi-Cal (California Medicaid); and (3) any Liens from the Department of Veterans Affairs (VA & CHAMP VA), TRICARE, Indian Health Services, or non- California state Medicaid agencies that were not disclosed in the Claims Questionnaire.

180. Who pays my Medical Liens?

The Trust will pay Medical Liens directly to Medicare (Parts A and B), Medi-Cal (California Medicaid), and PLRP Participating Private Health Plans, in addition to Department of Veterans Affairs (VA & CHAMP VA), TRICARE, Indian Health Services, and other state (non-California) Medicaid disclosed in the Claims Questionnaire on your behalf, where those Medical Liens are resolved by the Lien Resolution Administrator. These Medical Lien payments will come from your Personal Injury and/or Emotional Distress awards, and not from awards you receive for any other Claim Types.

You are responsible for paying Medical Liens to any private insurer or government agency with whom you resolve such Liens directly.  

181. If my finalized Medical Liens are less than what the Trust withheld from my Pro Rata 2 payment, will I receive the difference?

Yes, the Trust will reduce your total holdback as any applicable Medical Lien obligations are finalized or released and pay the previously withheld funds to you.

182. What happens if more than one Lien exceeds the gross awards paid to date and there is not enough money to pay all of the Liens in full?

For those Claimants who did not opt out of the PLRP, Medical Liens alone will never consume an entire payment because they are capped at 33%. In those situations where Medical Liens in combination with Non-Medical Liens exceed the payment amount, Liens will be paid in this order until the payment amount is used up, unless in a particular claim a different resolution method is agreed upon:                                                                                                                                     

(a) Medicare (Parts A and B)

(b) Medi-Cal/Other (non-California) state Medicaid disclosed in the Claims Questionnaire

(c) The Department of Veterans Affairs (VA & CHAMP VA), TRICARE, and Indian Health Services

(d) PLRP Participating Private Health Plans

(e) Other Liens according to a “first in time, first in right” policy in the date order in which the debt was perfected with, or recognized by, the applicable court or agency.