Short Answer

Medicare’s notice means it may be owed repayment from your injury recovery for accident-related medical bills it paid. The first letter usually identifies your claim and explains your duties; it often says not to pay yet. After you report a settlement, Medicare issues a Final Demand with the amount due, and you must pay within 60 days to avoid interest. North Carolina provider-lien caps do not limit Medicare’s federal recovery rights.

Understanding the Problem

You received a Medicare letter about a “lien” while your North Carolina personal injury claim is still active, and the notice says not to send money yet. You want to know what it means and what to do next. This is about whether, when, and how you must deal with Medicare before your settlement is disbursed in North Carolina.

Apply the Law

Under federal Medicare Secondary Payer rules, Medicare can make “conditional payments” for injury care and then seek reimbursement from any later settlement, judgment, or award. Early letters typically confirm your claim is open and outline your duty to cooperate. Medicare will later issue a Final Demand after you report settlement. You have 60 days from the Final Demand to pay, or interest accrues. In North Carolina, provider lien caps and fee limits do not cut down Medicare’s federally mandated recovery, and special wrongful death limits on medical bills do not block Medicare reimbursement.

Key Requirements

• Identify coverage and report: Confirm whether you have traditional Medicare or a Medicare Advantage/Part D plan and report the claim to Medicare’s recovery contractor.
• Review “conditional payments”: Check Medicare’s itemized list and dispute charges unrelated to the accident or duplicative bills.
• Notify settlement: When the case resolves, promptly report the gross settlement and procurement costs (fees/expenses) so Medicare can issue a Final Demand.
• Pay on time: Pay the Final Demand within 60 days to avoid interest; request any warranted reductions/waivers through the proper process.
• Coordinate other liens: North Carolina provider liens and fee caps apply to providers, not Medicare; do not rely on the 50% cap to limit Medicare’s recovery.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider liens) - Allows certain providers to assert liens on personal injury recoveries.
• North Carolina Gen. Stat. § 44-50 (Enforcement; fee/50% cap) - Limits what providers can take after attorney’s fees; does not limit Medicare’s federal recovery.
• North Carolina Gen. Stat. § 28A-18-2 (Wrongful death) - Sets payment priorities for medical/burial expenses from wrongful death proceeds; Medicare reimbursement still applies despite state caps.

Analysis

Apply the Rule to the Facts: Your letter likely means Medicare has opened a recovery file for your injury claim and is tracking what it paid. The instruction not to send money now is consistent with Medicare’s early notices, which come before a Final Demand is calculated. Your next steps are to confirm your coverage type, review any conditional payment list for accuracy, then report settlement details so Medicare can issue a Final Demand you must pay within 60 days.

Process & Timing

1. Who files: You or your attorney. Where: Medicare’s Benefits Coordination & Recovery Center (often via the MSPRP portal or by phone/mail). What: Report the injury claim, coverage type, accident details, and authorize representation. When: Early in the claim and whenever facts change.
2. Next: Obtain and review Medicare’s conditional payment summary; dispute unrelated codes/charges. When the case settles, report the gross amount and your fees/costs. Medicare then issues a Final Demand; review and, if needed, request a reconsideration or waiver. This can take a few weeks; timing varies.
3. Final: Pay the Final Demand within 60 days of its date to stop interest accrual. Your lawyer typically disburses this from settlement funds. For minors or incompetents, North Carolina courts generally approve settlements and direct payment of liens; the Clerk may hold funds as the order specifies.

Exceptions & Pitfalls

• Medicare Advantage/Part D: If you have a Medicare Advantage or Part D plan, the plan—not traditional Medicare—handles recovery, with its own notice, dispute, and payment process.
• Don’t pay too soon: Do not send money before the Final Demand; amounts often change after disputes or procurement-cost credits.
• NC lien caps don’t control Medicare: North Carolina’s 50% cap for provider liens and fee priorities do not limit Medicare’s federally required recovery, including from wrongful death proceeds.
• Code mismatches: Dispute non-accident or unrelated ICD-10 codes to avoid overpaying.
• Approval issues: For minors or incompetents, expect a judge to approve the settlement and direct lien payments; follow the order precisely.
• Interest risk: Missing the 60-day window triggers interest until paid; keep track of dates.

Talk to a Personal Injury Attorney

If you're dealing with a Medicare lien on a North Carolina injury claim, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at [919-341-7055].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.